Microdiscectomy

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 after surgery.

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.

© Spineworks Ltd 2005/2006