Micro Lumbar Discectomy
Why is this surgery done?
A herniated disc typically occurs when a degenerative disc breaks down, causing the disc to herniate, or protrude. This may result in pressure on or inflammation of the nearby nerves. This frequently causes buttock and leg pain. This surgery will remove the disc protrusion.
How is a micro lumbar discectomy done?
In the traditional approach, your surgeon will make a incision about 1 inch (or less) long, over the lower spine. When using a minimally invasive approach, a small tube is placed through the muscles of the back overlying the spine, then the opening is gently enlarged. At this point both surgeries are the same- a small piece of bone is removed, allowing access to the affected nerve. The nerve is moved and the ruptured disc is removed. Because the area is small, a microscope is used during the procedure.
What are my risks? What are common complications?
This is a common surgery with high satisfaction ratings. It is generally effective in relieving pain and improving weakness. Numbness or sensory complaints take the longest to improve. However, there is no guarantee that your pain will be relieved following surgery. You may experience some improvement of your symptoms, but you may have permanent damage that surgery cannot correct. There is a chance you will need more surgery due to new or recurrent symptoms.
While complications from surgery are uncommon, some can be serious and may include:
- Heart or lung problems from general anesthesia, which could be fatal
- Bleeding, which could require a transfusion
- Infection, which could require IV antibiotics and another operation
- Damage to the covering of the nerve (the dura), which causes a spinal fluid leak and could require a drainage procedure or another operation. Although rare, this damage could result in paralysis, pain or bowel and bladder dysfunction.
- Deep vein thrombosis (DVT)
What do I need to know before surgery?
If you take any blood thinners—for example Coumadin, aspirin, Plavix, Xeralto, Eliquis or Ticlid—make sure your surgeon is aware of this medication as soon as possible. You will be given specific instructions regarding any need to stop or change your current use of any blood-thinning medication. If necessary, your surgeon will get clearance from your cardiologist or other physician to ensure that this medication change is safe and appropriate for you based on your heart history, including prior heart attack, stent placement or open-heart surgery.
Stop taking aspirin-based products one week before surgery. Also, stop taking nonsteroidal anti-inflammatory drugs, such as ibuprofen, Naprosyn, Naproxen, Advil and Motrin, at least one week before surgery.
Please do not eat or drink anything after midnight the day of your surgery. This includes water, coffee, chewing gum and hard candies. You may brush your teeth with toothpaste the morning of surgery.
Some daily medications may be taken the day of surgery with a sip of water. Medications that are appropriate to take the morning of surgery will be discussed with you by the hospital staff or your surgeon’s nurse.
General discharge instructions
You may leave the hospital with a waterproof dressing on your incision site. This dressing should remain in place for two days after you return home. Under the dressing will be Steri-Strips, which are small adhesive strips across the surgical incision. Leave these Steri-Strips on the incision and allow them to fall off naturally- this usually occurs within two weeks. If after two weeks the Steri-Strips have not fallen off, you should remove them.
After removing the dressing, your incision can be open to the air. It is important for a family member to look at your incision each day for one week after surgery to monitor it for any changes as the healing process continues.
If staples or sutures were used to close your incision, they will need to be removed 10 – 14 days after your surgery. Please call your surgeon’s office at (317) 396-1300 to schedule an appointment for this removal.
Some surgeons use surgical skin glue that does not require any incisional care.
You may shower any time after surgery, but pay attention to your body and don’t shower if you are feeling lightheaded or tired. Simply pat your incision dry after your shower and leave the incision open to the air under your clothing.
Do not take tub baths or Jacuzzi baths and do not go swimming for the first three weeks after your surgery.
General anesthesia, inactivity after surgery and pain-relieving prescription narcotics may cause constipation after surgery. It may be helpful to take a stool softener and/or laxative after surgery. These medications, which include Colace, Miralax and Senokot, may be purchased over the counter at your local pharmacy.
What should I expect while recovering?
You can expect incision pain during the first several days after surgery. Typically, any leg pain will improve first. You may also experience numbness and tingling because of nerve damage caused by nerve compression. This will typically get better after a few weeks or months as the nerve heals. Please note, nerve damage does not always resolve after surgery.
Back discomfort and stiffness are common after surgery. To help you manage the pain, you will be given a prescription for pain medication when you leave the hospital or surgery center. As the pain improves, you may change to Tylenol or Advil to help with pain control. An ice pack along the incision line will also help with any discomfort you feel.
Possible physical therapy exercises
After leaving the hospital, physical therapy is usually not necessary for most patients. Your best therapy is walking, which increases blood flow to the spine and assists in the healing process. Try walking on a structured basis, beginning slowly at first and progressing on a regular basis as your pain begins to lessen.
If your recovery is slower, you may need additional therapy after surgery. If needed, physical therapy will be discussed with you at your follow-up appointment.