Lumbar
Microdiscectomy
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To
view an animation of the surgery, click on the projector
to the left. |
| The
Surgeon's Role |
|
Your
surgeon will:
- review
your neurological history and examination;
- review
your diagnostic studies (such as a myelogram, CAT
scan or MRI);
- plan
a surgical approach; and
- review
the procedure with you.
|
| Your
Role |
|
You
must have a thorough understanding of the diagnosis (what
is causing your back and/or leg symptoms) and the risks
and benefits of the proposed surgery. Once you are confident
that surgery is the correct option for you, turn your
thoughts to the future and the recovery process. |
| Beginning
the Operation |
|
In
the operating room, a lumbar microdiscectomy begins
with a small incision in your lower back. Through this
opening, your surgeon will insert microsurgical instruments.
Because the work is viewed through a microscope (Fig.
6, above), this approach requires a relatively
small incision.
|
| Reaching
The "Pinched" Nerve |
|
Guided
by diagnostic studies, your surgeon will remove a small
portion of bony material from the back of your vertebra
(Fig. 7). Once this material is removed, the
surgeon can locate the exact area where the nerve root
is being pinched.
|
| Identifying
the Cause of the Pressure |
|
Once
the "pinched" nerve is located, the extent of the pressure
on the nerve can be determined. Using microsurgical
procedures, your surgeon will remove the ruptured portion
of the disc and any disc fragments which have broken
off from the main disc (Fig. 8). The amount
of work required to complete your microdiscectomy will
depend in part on the number of disc fragments present
and the difficulty presented in finding and removing
them.
|
| Surgery
Video |
|
This is
video of a microdiscectomy, and may not be suitable for
all audiences. If you would like to view the video, click
on the picture.

|
| Closing
the Incision |
|
The
operation is completed when each layer of the incision
is closed with suture material (stitches) or surgical
staples. If the outer incision is closed with staples
or non-absorbable sutures, they will have to be removed
after the incision has healed. |
| The
Healing and Recovery Process |
|
Once
the ruptured disc has been removed, healing can begin
(Fig. 9). Healing is the body's natural process
of restoring its damaged tissues to a normal, or nearly
normal condition. Healing occurs on its own, but is
influenced by such factors as general good health,
physical fitness, nutrition and rest. Recovery is
the process during which you work at becoming
well. You must commit yourself to staying in good health
(exercising), maintaining a positive mental attitude
and following your physician's instructions.
|
| Have
Realistic Expectations |
|
Recognize
that healing and recovery will not happen overnight.
It is a process. You may find that much of your
progress will be like taking "two steps forward and one
step back." Accept it! And then do all that you can to
make sure your steps "forward" are large ones and your
steps "backward" are small ones. |
| Be
Patient and Persistent |
|
During
the recovery period in the hospital and at home, try
to rebuild your strength gradually. Rest when you feel
fatigued - but be persistent in your efforts.
It
is important for you to recognize that we all heal
at a different rate. The speed at which you will
recover depends in part on your age, your general
level of health, your overall physical fitness and
your mental attitude. Generally, you will heal more
slowly if you are overweight, out of shape or smoke,
or if you are a diabetic or have other pre-existing
medical problems. |
| Expect
Some Pain After Surgery |
|
It
is normal to have some pain after any operation. After
a lumbar microdiscectomy, there may be some leg "aching" which
occurs as the nerve(s) attempts to heal. You also may
feel some muscle spasms across your back and down your
leg(s). And if there was inflammation in the nerve
root, some pain may persist until this inflammation
diminishes. You will be given appropriate medication
to control your pain, relieve back spasms and reduce
inflammation. |
| Be
Prepared for Some Emotional Changes |
|
It
is not unusual to feel tired and discouraged for several
days following surgery. These feelings may be your body's
natural reaction to the cutback of extra hormones it
generated during surgery. Although some emotional letdown
can be expected, you must not let it get in the way of
your recovery. Don't look back at past problems. It is
important for you to look at even the smallest positive
steps you make as progress towards your recovery goal. |
| Develop
a Positive Mental Attitude |
|
You
should begin to work on a positive mental attitude even before the
surgery is performed. Direct your energies toward the solution of
your problem, rather than worrying about what caused
your problem. Don't be discouraged by minor setbacks
during the recovery process. Concentrate on the progress
you make, and will continue to make in the future.
Commit
to a Healthy Lifestyle
Now
is the time to commit yourself to a healthier lifestyle.
You can begin by taking these important steps:
*
Watch your weight: If you are overweight,
you must gradually return to your proper weight.
Crash diets rarely work. Commit yourself to better
eating habits and stay with them for the rest
of your life.
* Become
more active: Your physician will tell you
when you can resume normal physical activities
after surgery. Make up your mind now that you
will develop a regular aerobic exercise routine,
such as walking, swimming or riding a bike. However, always
check with your physician before starting any
exercise program.
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Related
links:
Lumbar
microdiscectomy - page 1
Lumbar microdiscectomy
- page 2
Lumbar microdiscectomy
- page 4
Lumbar anatomy
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