Our Summary

This research paper discusses a new way of using ultrasound technology during a specific type of back surgery called tubular microdiscectomy, which is often performed to treat a herniated disc in the lower back. The new technique involves using ultrasound during the surgery to visualize the affected area and the surrounding nerve structures in real-time. After the removal of the disc (discectomy) and physical examination, the ultrasound showed that the pressure on the thecal sac (a protective membrane around the spinal cord) and the nerve root was relieved. The patient recovered well from the procedure, with less pain and improved strength. After the surgery, an MRI scan revealed a small piece of disc that was left behind, but it was not causing any symptoms and it was identified in retrospect on the ultrasound. The authors suggest that this minimally invasive use of ultrasound could become a helpful addition to the visual and physical examination during such surgeries, but more experience and understanding of interpreting the ultrasound images during surgery is needed.

FAQs

  1. What is the role of ultrasound during a microdiscectomy?
  2. Can ultrasound detect any residual disc fragments after a microdiscectomy?
  3. What are the potential benefits of using minimally invasive ultrasound during tubular microdiscectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about microdiscectomy is to follow postoperative instructions carefully, including avoiding heavy lifting and bending at the waist for a period of time to allow for proper healing of the surgical site. It is also important to attend follow-up appointments and physical therapy as recommended to aid in recovery and prevent future issues.

Suitable For

Patients who are typically recommended for microdiscectomy are those with a herniated disc causing symptoms such as leg pain, weakness, or numbness that have not responded to conservative treatments such as physical therapy or medication. Microdiscectomy is often recommended for patients with a single-level disc herniation, particularly at the L4-L5 or L5-S1 levels. Additionally, patients who have significant neurological deficits or progressive weakness may also be candidates for microdiscectomy to relieve pressure on the spinal nerves.

Timeline

Before microdiscectomy:

  1. Patient experiences pain, weakness, and/or numbness in the lower back or leg.
  2. Patient undergoes imaging tests such as MRI to confirm the diagnosis of a herniated disc.
  3. Conservative treatments such as physical therapy or medication may be attempted first.

During microdiscectomy:

  1. Ultrasound is used during surgery to provide real-time visualization of the herniated disc and neural elements.
  2. The surgeon performs the discectomy and assesses decompression of the thecal sac and nerve root.
  3. The patient tolerates the procedure well and experiences resolution of preoperative pain and improvement in strength.

After microdiscectomy:

  1. Postoperative MRI may be performed to confirm the success of the surgery.
  2. The patient may experience some residual symptoms or complications, such as a residual asymptomatic disc fragment.
  3. Further follow-up appointments and rehabilitation may be necessary to ensure full recovery and prevent future disc herniation.

What to Ask Your Doctor

  1. How does microdiscectomy compare to other treatment options for my herniated disc?
  2. What are the potential risks and complications associated with microdiscectomy?
  3. What is the expected recovery time and rehabilitation process after microdiscectomy surgery?
  4. Will I need physical therapy or other postoperative care after the procedure?
  5. How successful is microdiscectomy in relieving pain and improving function in patients with herniated discs?
  6. Are there any long-term implications or considerations I should be aware of after undergoing microdiscectomy?
  7. How often do patients experience recurrence of symptoms after microdiscectomy surgery?
  8. Can you explain the role of ultrasound during microdiscectomy and how it may benefit the surgical outcome?
  9. What experience do you have with using ultrasound during microdiscectomy procedures?
  10. Are there any specific precautions or instructions I need to follow before and after the surgery to optimize my results?

Reference

Authors: Tawil ME, Chryssikos T, Dada A, Ambati VS, Macki M, Zammar SG, Tan W, Tan L. Journal: Neurosurg Focus Video. 2024 Apr 1;10(2):V6. doi: 10.3171/2024.1.FOCVID23206. eCollection 2024 Apr. PMID: 38616912