A microdiscectomy, also known as microdecompression, is a surgical procedure in which bone or disc material is removed from around a nerve root in the spinal cord. The procedure is meant to alleviate pressure exerted on the nerve root, which could result in significant pain relief for the patient. A microdiscectomy is most often performed on patients suffering from herniated discs, albeit usually as a last resort. The surgery, although considered an outpatient procedure, deals with a delicate area of the human body and could see serious complications. Incidents that adversely affect the patient are rare, however, occurring in 1 to 2 percent of patients.
Doctors usually advise patients suffering from herniated discs to try other methods of treatment before resorting to microdiscectomy surgery. The characteristic leg pain experienced by disc hernia patients can often be relieved by using anti-inflammatory medication or through the use of a physical therapy regimen targeted specifically towards spinal cord readjustment. A microdiscectomy is usually recommended only if the patient does not report any signs of improvement after three to six months of treatment.
During a microdiscectomy, surgeons make an incision in the patient's lumbar area, taking care to minimize any damage to the back muscles. The muscles are then pushed aside to allow for visibility of the spinal cord. Surgeons remove the ligamentum flavum, a membrane covering the nerve roots, and begin to remove small bits of tissue and bone that exert excess pressure on the roots. The inside facet joint is usually removed, both to relive pressure and to allow for easier movement around the nerve root. The root itself is gently moved aside to allow access to the disc material, which is then carefully removed to provide further relief.
Success rates for this form of spine surgery are very favorable, with hospitals reporting rates from 90 to 95 percent. Since the operation causes no major alterations to the joints, muscles, and other tissues involved, patients are usually discharged from the hospital on the day of the surgery itself. In some cases, doctors might recommend avoiding strenuous activities for the first six weeks after the procedure, so as to guarantee complete healing.
Complications rarely arise during or after a microdiscectomy, and generally only occur as a result of the surgeon's negligence. Patients might experience dural tears that result in leaking cerebrospinal fluid, but the ruptures tend to heal after two or three days of bed rest. The nerve root might get damaged during the surgery, resulting in bleeding, possible infection, and neurological damage, but this is largely unlikely to occur in the care of a trained professional.