Microdiscectomy is a surgical treatment of sciatica, by removing pieces of disc
material which are irritating the nerve root. This is a procedure carried out
for a disc prolapse, herniation or disc bulge. Essentially this condition of
an intervertebral disc occurs in a disc which is degenerate, in other words
wearing thin. If this disc is in this state it is more likely that a physical
insult will tear the wall of the disc allowing the inner tube of the disc to
protrude through the rent in the outer wall. Unfortunately the result of this
is often is that the inner tube will irritate one of the nerves going down the
legs. This condition will often settle on its own with the passage of time or
with the help of physiotherapy, chiropraxy or osteopathy. It may also be improved
by the use of epidurals. If the condition does not settle, however, or there
is a major loss of function of a nerve, in other words profound numbness, severe
pain, or loss of function of a muscle, then surgery becomes an option.
This sort of operation is done under a general anaesthetic and takes about 45
minutes to do. It will require a hospitalisation period of around three days.
You will be allowed home once you can wash and dress yourself, move freely and
have gone up and down the stairs. A period of three days is not set in stone
but is about average for most patients. It will take you about six weeks to
get over the general effects of the operation in terms of wound healing and
you will be allowed back to most functional activities fairly rapidly after
surgery, provided your condition allows it. The stitches used in surgery will
dissolve therefore the wound requires minimal attention after discharge.
The risks and complications of such surgery are obviously the anaesthetic itself.
There is a small risk of nerve root injury and a small risk of cerebro spinal
fluid leak leading to headache. This tends to be treated by bed rest. More usual
risks are those of infection or deep vein thrombosis which will be guarded against
by the use of prophylactic antibiotics and by the use of TED. stockings. You
will also be mobilised the day after the operation to further prevent deep vein
thrombosis or clot formation.
After surgery you will also be mobilised by the physiotherapist who will pay
attention to mobilising your nerves so that they do not get stuck in scar tissue
Sometimes after this form of surgery the leg pain can be exacerbated; this is
due to inflammation already present in the nerve roots being increased by surgical
contact during the operation. This tends to settle quite rapidly.