Our Summary

This study looked at how different factors before surgery might impact the results of a specific type of back surgery called minimally invasive lumbar microdiscectomy. This surgery is used to treat a condition called lumbar disc herniation, where a disc in the spine pushes out of its usual place. The researchers looked at patients’ medical records from 2016 to 2020 to see how different factors might have influenced their recovery.

They used three measures to assess the patients’ recovery: the Oswestry Disability Index (ODI) and two visual analog scales (VAS) for leg and back pain. They checked these scores before surgery, immediately after, six months later, and a year later.

They found that factors like age, gender, body mass index, whether the patient smoked or not, whether they had other health conditions, whether they had a preoperative epidural steroid injection, whether they had physiotherapy, and the level of disc herniation didn’t make a statistically significant difference to the scores. However, younger patients, men, non-smokers, those with symptoms for less than six weeks, and those with disc herniation at a certain level (L3 to L4) showed greater improvements in the ODI scores at all time points.

The researchers believe that these findings might help doctors better advise their patients about what to expect from this surgery, which could lead to better results and help decide the best time to operate.

FAQs

  1. What is minimally invasive lumbar microdiscectomy used to treat?
  2. What factors were found to influence the recovery of patients after minimally invasive lumbar microdiscectomy?
  3. How might these findings impact the advice doctors give to their patients about minimally invasive lumbar microdiscectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about microdiscectomy is to discuss any lifestyle factors that could impact their recovery, such as smoking and physical activity. Additionally, setting realistic expectations about the outcome of the surgery based on factors like age, gender, and the level of disc herniation can help the patient better prepare for the procedure and post-operative recovery. It’s important for patients to communicate openly with their healthcare provider about any concerns or questions they may have before undergoing microdiscectomy.

Suitable For

Patients who are typically recommended for microdiscectomy are those with lumbar disc herniation causing significant pain, numbness, or weakness in the legs. Other factors that may influence the recommendation for surgery include younger age, male gender, non-smoking status, shorter duration of symptoms, and disc herniation at certain levels in the spine. Ultimately, the decision for surgery should be made on a case-by-case basis after thorough evaluation by a spine specialist.

Timeline

Before microdiscectomy:

  • Patient experiences symptoms of lumbar disc herniation such as back pain, leg pain, and numbness
  • Patient undergoes imaging tests like MRI to confirm the diagnosis
  • Patient may try conservative treatments like physical therapy, medication, and injections to manage symptoms
  • Patient discusses surgical options with their healthcare provider and decides to proceed with microdiscectomy

After microdiscectomy:

  • Patient undergoes minimally invasive lumbar microdiscectomy surgery
  • Patient is monitored in the hospital for a short period of time after surgery
  • Patient may experience some post-operative pain and discomfort
  • Patient gradually resumes normal activities under the guidance of their healthcare provider
  • Patient attends follow-up appointments to assess recovery and monitor symptoms
  • Patient may experience improvements in back and leg pain, as well as overall function over time

Overall, the timeline for a patient before and after microdiscectomy involves a period of pre-operative evaluation and decision-making followed by surgical intervention and post-operative recovery and rehabilitation.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with microdiscectomy surgery?
  2. How long is the recovery process expected to be after microdiscectomy surgery?
  3. Will I need physical therapy after the surgery, and if so, how long will it be necessary?
  4. What type of pain relief options will be available to me after the surgery?
  5. Are there any restrictions on activities or movements I should be aware of after the surgery?
  6. How likely is it that the herniated disc will reoccur in the future after the surgery?
  7. What are the success rates of microdiscectomy surgery for patients with similar conditions to mine?
  8. How many microdiscectomy surgeries have you performed, and what is your success rate?
  9. Are there any alternative treatment options to consider before opting for microdiscectomy surgery?
  10. What can I do to optimize my recovery and improve the outcomes of the surgery?

Reference

Authors: Mehendiratta D, Patel P, Bhambhu V, Chaudhary K, Dalvie S. Journal: Asian J Neurosurg. 2022 Aug 24;17(2):248-254. doi: 10.1055/s-0042-1750839. eCollection 2022 Jun. PMID: 36120625