Our Summary

This research paper discusses lumbar disk herniations, which are common and often lead to leg pain, weakness, and unusual sensations. However, most patients get better with non-surgical treatments. Surgery is only considered for patients who continue experiencing significant pain after at least six weeks of non-surgical treatment, those who have severe or worsening muscle weakness, or those who show symptoms of bowel or bladder dysfunction. The paper reviews factors to consider before and after surgery, as well as the surgical technique for a microdiscectomy, a procedure to treat herniated lumbar disks.

FAQs

  1. What is a microdiscectomy and how does it treat herniated lumbar disks?
  2. When is surgery considered for patients with lumbar disk herniations?
  3. What factors should be considered before and after opting for surgery for lumbar disk herniations?

Doctor’s Tip

A doctor might tell a patient that after a microdiscectomy, it is important to follow a personalized rehabilitation plan that includes physical therapy and exercises to strengthen the back and core muscles. It is also important to avoid heavy lifting and bending at the waist to prevent further injury to the spine. Additionally, maintaining a healthy weight and practicing good posture can help prevent future disk herniations. Regular follow-up appointments with the doctor are important to monitor recovery and address any concerns or complications.

Suitable For

Patients who are typically recommended microdiscectomy include:

  1. Patients who have not experienced improvement in symptoms after at least six weeks of non-surgical treatments such as physical therapy, medication, and rest.

  2. Patients who have severe or worsening muscle weakness in the legs, which can affect mobility and daily activities.

  3. Patients who have symptoms of bowel or bladder dysfunction, which can indicate a more severe compression of the nerves in the lower back.

  4. Patients who have a confirmed diagnosis of a herniated lumbar disk through imaging tests such as MRI or CT scans.

  5. Patients who have a herniated lumbar disk that is causing significant pain, numbness, tingling, or weakness in the legs, making it difficult to perform daily activities.

Overall, microdiscectomy is recommended for patients who have failed conservative treatments and continue to experience debilitating symptoms that significantly impact their quality of life. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if microdiscectomy is the best course of action for their individual case.

Timeline

Before microdiscectomy:

  • Patient experiences lower back pain, leg pain, weakness, and unusual sensations
  • Patient undergoes at least six weeks of non-surgical treatments such as physical therapy, medication, and injections
  • If symptoms persist or worsen, patient may be recommended for surgery
  • Patient undergoes pre-operative evaluations and tests to assess overall health and determine if surgery is appropriate

After microdiscectomy:

  • Patient undergoes microdiscectomy surgery to remove the herniated portion of the lumbar disk
  • Patient stays in the hospital for a short period of time for recovery
  • Patient may experience some pain and discomfort immediately after surgery
  • Patient gradually resumes normal activities and physical therapy to strengthen the back muscles
  • Patient follows up with their surgeon for post-operative care and monitoring of recovery progress
  • Patient experiences relief from leg pain, weakness, and unusual sensations as the herniated disk is removed
  • Patient continues to follow up with their surgeon for long-term monitoring of their back health and to address any potential complications or recurring symptoms.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with microdiscectomy surgery?
  2. What is the success rate of microdiscectomy surgery in relieving symptoms and improving function?
  3. How long is the recovery process after microdiscectomy surgery and what can I expect in terms of pain and activity limitations?
  4. Will I need physical therapy or rehabilitation after the surgery? If so, for how long and what will it involve?
  5. Are there any specific restrictions or precautions I should follow after the surgery to ensure optimal healing?
  6. How soon can I expect to see improvement in my symptoms after the surgery?
  7. What are the chances of the herniated disk reoccurring after microdiscectomy surgery?
  8. Are there any alternative treatment options to consider before opting for surgery?
  9. How experienced are you in performing microdiscectomy surgeries and what is your success rate with this procedure?
  10. Are there any long-term effects or complications associated with microdiscectomy surgery that I should be aware of?

Reference

Authors: Millhouse PW, Schroeder GD, Kurd MF, Kepler CK, Vaccaro AR, Savage JW. Journal: Clin Spine Surg. 2016 Feb;29(1):17-20. doi: 10.1097/BSD.0000000000000353. PMID: 26710186