Our Summary

This research paper discusses the treatment options for herniated disks in the lower spine. When someone has a herniated disk, they may experience sudden back and leg pain, tingling sensations, and in severe cases, weakness or difficulty moving their foot.

Typically, doctors first try to treat this condition without surgery for 6-8 weeks. This treatment can include steroids, anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest. If the patient’s symptoms don’t improve after this period, then they might be recommended for surgery, specifically a procedure called a microdisectomy.

This surgery might be recommended earlier for patients whose symptoms are severe or getting worse. The paper also discusses what doctors should consider before and after the surgery, as well as the specific techniques used for this less invasive type of surgery.

FAQs

  1. What is a microdiscectomy and when is it typically recommended?
  2. What are the preoperative and postoperative considerations for a microdiscectomy?
  3. What symptoms might lead to a patient requiring a microdiscectomy?

Doctor’s Tip

A doctor might advise a patient undergoing microdiscectomy to follow postoperative care instructions carefully, including avoiding heavy lifting and strenuous activity for a period of time to allow for proper healing of the surgical site. They may also recommend physical therapy to help strengthen the muscles surrounding the spine and prevent future injury. It is important for patients to communicate any new or worsening symptoms to their healthcare provider to ensure proper recovery and prevent complications.

Suitable For

Patients who are typically recommended for microdiscectomy are those who have not responded to conservative treatments for at least 6-8 weeks and continue to experience symptoms such as back and leg pain, radicular pain, paresthesias, weakness, or foot drop. These patients may have a herniated disk in the lumbar spine causing compression on the spinal nerves. Patients with severe or progressive neurological deficits may also be considered for earlier surgical intervention. The goal of microdiscectomy is to relieve the pressure on the nerves and alleviate the symptoms associated with the herniated disk.

Timeline

  • Before microdiscectomy:
  1. Patient presents with sudden onset of back and leg pain in a myodermatomal distribution.
  2. Symptoms may include radicular pain, paresthesias, and in extreme cases weakness or foot drop.
  3. Patient undergoes conservative treatment for 6-8 weeks with a combination of steroids, nonsteroidal anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest.
  4. If symptoms do not improve, surgical intervention with microdiscectomy is recommended.
  • After microdiscectomy:
  1. Patient undergoes minimally invasive/less invasive microdisectomy surgery.
  2. Recovery time varies, but most patients experience relief from leg pain immediately after surgery.
  3. Patients are typically discharged from the hospital within a few days and are advised to avoid heavy lifting and bending for several weeks.
  4. Physical therapy may be recommended to help strengthen the back muscles and improve flexibility.
  5. Most patients are able to return to normal activities within 4-6 weeks after surgery.
  6. Long-term outcomes are generally positive, with the majority of patients experiencing significant improvement in symptoms and quality of life.

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. What is the typical recovery time and rehabilitation process following microdiscectomy surgery?
  4. Are there any alternative treatments or procedures that could be considered before undergoing microdiscectomy?
  5. How long will I need to stay in the hospital after the surgery, and what is the expected timeline for returning to normal activities?
  6. Will I need physical therapy or other postoperative care after the surgery?
  7. How likely is it that the herniated disc may reoccur after microdiscectomy surgery?
  8. Will I need any additional imaging or follow-up appointments to monitor my recovery after the surgery?
  9. Are there any specific lifestyle changes or precautions I should take after undergoing microdiscectomy?
  10. What is the long-term outlook for my back pain and overall spinal health following microdiscectomy surgery?

Reference

Authors: Badlani N, Yu E, Ahn J, Kurd MF, Khan SN. Journal: Clin Spine Surg. 2016 Apr;29(3):108-10. doi: 10.1097/BSD.0000000000000369. PMID: 26945129