Our Summary

This paper is a comprehensive review of the complications that can occur from three different types of surgery used to treat issues in the lower back, namely open, microendoscopic, and percutaneous microdiscectomy. The researchers found and analyzed 42 studies out of 9,504 articles that met their criteria. They found that complications occurred in around 10-13% of surgeries, irrespective of the type of technique used. The specific complications and their rates varied, but there were no major differences across the surgical techniques, except for a slightly higher rate of nerve damage during percutaneous procedures compared to microendoscopic ones. This information could be useful to doctors and patients when considering the potential risks and benefits of these surgeries.

FAQs

  1. What types of surgeries for lower back issues were discussed in the paper?
  2. What was the general rate of complications found in the studied surgeries?
  3. Was there a difference in the rate of complications across the different surgical techniques?

Doctor’s Tip

A doctor might tell a patient undergoing a microdiscectomy that while complications are rare, they can include infection, nerve damage, and spinal fluid leaks. It is important to follow post-operative instructions carefully, including avoiding heavy lifting and bending, to ensure a successful recovery. Physical therapy may also be recommended to help strengthen the back and prevent future issues.

Suitable For

Patients who are typically recommended microdiscectomy are those who have a herniated disc in the lumbar spine that is causing severe pain, weakness, or numbness in the legs. These patients may have tried conservative treatments such as physical therapy, medications, and injections without success. Microdiscectomy is often recommended for patients who have not experienced relief from non-surgical treatments and who have significant functional limitations due to their symptoms. Additionally, patients who have a herniated disc that is compressing a nerve root and causing neurological deficits such as weakness, numbness, or tingling in the legs may also benefit from microdiscectomy.

Timeline

Before microdiscectomy:

  1. Patient experiences lower back pain, leg pain, weakness, and numbness.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to identify the cause of the symptoms.
  3. Patient may try conservative treatments such as physical therapy, medications, and steroid injections.

After microdiscectomy:

  1. Patient is evaluated by a surgeon and deemed a candidate for microdiscectomy.
  2. Patient undergoes preoperative testing and preparation for surgery.
  3. Patient undergoes microdiscectomy procedure to remove the herniated disc material pressing on the nerve.
  4. Patient is monitored in the hospital for a few days post-surgery.
  5. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  6. Patient experiences a gradual reduction in pain and improvement in symptoms over the following weeks and months.
  7. Patient follows up with the surgeon for postoperative care and monitoring of recovery progress.

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 in relieving pain and improving function?
  3. How long is the recovery period after microdiscectomy surgery?
  4. Are there any restrictions or limitations on activities following microdiscectomy surgery?
  5. What is the likelihood of needing additional surgery in the future after microdiscectomy?
  6. What alternative treatment options are available for my condition?
  7. How experienced are you in performing microdiscectomy surgeries?
  8. Are there any specific factors that may increase my risk of complications during or after microdiscectomy surgery?
  9. How will you monitor my progress and manage any post-operative pain or complications?
  10. Are there any long-term implications or considerations to be aware of after undergoing microdiscectomy surgery?

Reference

Authors: Shriver MF, Xie JJ, Tye EY, Rosenbaum BP, Kshettry VR, Benzel EC, Mroz TE. Journal: Neurosurg Focus. 2015 Oct;39(4):E6. doi: 10.3171/2015.7.FOCUS15281. PMID: 26424346