An endoscopic microdiscectomy is a minimally-invasive surgical procedure in which a surgeon removes a small part of the vertebra and disc if it is compressing a nerve. Patients who have a herniated disc often experience lower back pain or leg pain as a result of the bulging disc pressing on a nerve. Microdiscectomies are most effective for patients who have leg pain, though the procedure may help alleviate lower back pain as well. The surgery uses a small incision and an endoscope, which is a thin tube with a light and camera on the end, to remove the bone and disc.
Surgery, even procedures that only require a small incision like an endoscopic microdiscectomy, are typically the last resort for treatment of a herniated disc accompanied by leg pain. Patients who experience these problems usually try medications to relieve pain and inflammation, often combined with strengthening exercises and stretches before doctors consider surgery. Leg pain that persists for more than six weeks after a disc herniation or a disc problem that causes incontinence are the most common reasons for surgery. Postponing the surgery may make it less successful, so surgeons usually do a microdiscectomy between six weeks and three months after injury.
During an endoscopic microdiscectomy, the surgeon makes a small cut in the middle of the lower back and pulls the muscles surrounding the spine up and out of the way. He then inserts the endoscope to help him see inside the back, and uses special tools to remove small pieces of the vertebra and disc so that they do not irritate the nerve. The surgeon then cleans the wound with an antibiotic solution, moves the muscles back into place, and stitches the wound closed. Patients who do not have complications can usually go home several hours after surgery.
Most patients who undergo an endoscopic microdiscectomy do not have recurring disc problems, and their pain subsides immediately after surgery since there is no pressure on the nerve root. The recovery period after surgery is very short compared to other, more invasive spinal surgeries. Microdiscectomy patients can usually return to work and resume normal activities within a few days, though some surgeons do advise patients against heavy lifting, twisting, or bending for four to six weeks after the procedure.
Severe complications during or after an endoscopic microdiscectomy are rare, though some patients do have problems. Damage to the nerve root and urinary or bowel incontinence after surgery are possible. Patients who experience a dural tear that results in a leak of cerebrospinal fluid during the operation may have a slightly longer recovery time because they need to rest for several days while the tear heals. Other potential problems include bleeding and infection at the surgical site, so it is important that discectomy patients follow their doctors' instructions for wound care after surgery.
