Our Summary

This research paper discusses a case where a patient needed spinal surgery due to a disc problem in the lower back that was causing severe leg pain. The surgery was initially carried out by an interventional pain management specialist (IPMS), who is not specifically trained in spinal surgery. This specialist first tried to manage the patient’s pain with steroid injections, but this made the pain worse. The IPMS then performed a type of minor surgery called a microdiscectomy.

However, half a year later, the patient’s condition worsened, so they saw a specialist in spinal neurosurgery. This surgeon performed another surgery and found no evidence that the previous microdiscectomy had actually been carried out - it was a “sham” operation. After this second surgery, the patient’s condition improved.

The research paper concludes that only professionals specifically trained in spinal surgery, such as neurosurgeons and orthopedists, should perform such surgeries, not IPMSs. This case serves as a warning about the potential dangers of non-specialists performing complex surgeries.

FAQs

  1. What is a microdiscectomy and who should perform it?
  2. How did the patient’s condition change after the second surgery, and was it different from the first one?
  3. What are the potential dangers of non-specialists performing complex surgeries like a microdiscectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about microdiscectomy is to ensure that the surgery is being performed by a specialist trained in spinal surgery, such as a neurosurgeon or orthopedist. It is important to do thorough research and ask questions about the surgeon’s qualifications and experience before undergoing any type of spinal surgery. Additionally, following post-operative instructions and attending follow-up appointments are crucial for a successful recovery.

Suitable For

Typically, patients who are recommended microdiscectomy are those who have a herniated disc in the lower back that is causing severe pain, weakness, or numbness in the legs. These patients may have tried conservative treatments such as physical therapy, medication, or steroid injections without success. Microdiscectomy is often recommended for patients who have not seen improvement with conservative treatments and who have significant nerve compression or dysfunction due to the herniated disc. It is important for patients to be evaluated by a specialist in spinal surgery, such as a neurosurgeon or orthopedist, to determine if microdiscectomy is the appropriate treatment option for their specific condition.

Timeline

  • Patient experiences severe leg pain due to a disc problem in the lower back
  • Patient sees an interventional pain management specialist (IPMS) who attempts to manage the pain with steroid injections
  • Steroid injections worsen the pain, leading to the IPMS performing a microdiscectomy
  • Six months later, the patient’s condition worsens, prompting a visit to a specialist in spinal neurosurgery
  • Spinal neurosurgeon performs a second surgery and discovers that the previous microdiscectomy was not actually performed
  • Patient’s condition improves after the second surgery
  • Research paper concludes that only professionals specifically trained in spinal surgery should perform such surgeries to avoid potential dangers of non-specialists performing complex surgeries

What to Ask Your Doctor

  1. What specific training and experience do you have in performing microdiscectomy surgeries?
  2. What are the potential risks and complications associated with microdiscectomy surgery?
  3. What is the success rate of microdiscectomy surgery for patients with my specific condition?
  4. What are the expected outcomes and recovery time after microdiscectomy surgery?
  5. Are there any alternative treatments or procedures that I should consider before opting for microdiscectomy surgery?
  6. How many microdiscectomy surgeries have you performed, and what is your success rate?
  7. What is the likelihood of needing additional surgery or treatments after a microdiscectomy?
  8. How long will I need to stay in the hospital after the surgery, and what is the expected timeline for returning to normal activities?
  9. Will I need physical therapy or rehabilitation after the surgery?
  10. Are there any specific post-operative care instructions or precautions that I should be aware of?

Reference

Authors: Ghaly RF, Perciuleac Z, Candido KD, Knezevic NN. Journal: Surg Neurol Int. 2020 Dec 29;11:467. doi: 10.25259/SNI_672_2020. eCollection 2020. PMID: 33500805