Microdiskectomy

ExitCare Image Your spine is made up of bones called vertebrae. Oval-shaped disks filled with a thick liquid sit between the vertebrae. The disks function like cushions and keep the bones from rubbing together. However, an injury or normal aging can cause a disk to bulge out (herniated disk). The herniated disk can press on a nerve root, which is painful. The pain may be in the lower back, or it might shoot down a leg. There also may be tingling or numbness. One way to stop the pain is with a minimally invasive surgery called microdiskectomy. The part of the disk that sticks out from the spine is removed. Only a small surgical cut (incision) is made in the back. Microdiskectomy is easier on the muscles and other tissues than traditional surgery.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies.

  • The last time you had anything to eat or drink. This includes water, gum, and candy.

  • All medicines you are taking, including herbs, eyedrops, over-the-counter medicines and creams.

  • Blood thinners (anticoagulants), aspirin, or other drugs that could affect blood clotting.

  • Any history of blood clots.

  • Any history of bleeding or other blood problems.

  • Use of steroids (by mouth or as creams).

  • Previous problems with anesthesia.

  • Family history of anesthetic complications.

  • Possibility of pregnancy, if this applies.

  • Previous surgery.

  • Smoking history.

  • Any recent symptoms of colds or infections.

  • Other health problems.

RISKS AND COMPLICATIONS

  • Leaking of spinal fluid. If this happens, you will need to stay in bed for a few days.

  • Bleeding.

  • Pain.

  • Infection near the incision.

  • Nerve damage.

  • Blood clot in a leg. The clot can move to the lungs. This can be very serious.

  • A herniated disk might come back (recur) and require additional surgery.

BEFORE THE PROCEDURE

  • A medical evaluation will be done. This may include:

  • A physical exam.

  • Blood tests.

  • A test that checks heart rhythm (electrocardiography).

  • Imaging tests such as a myelogram, chest X-ray, or MRI.

  • Ask your caregiver about changing or stopping your regular medicines.

  • You may need to stop using aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). This includes prescription drugs and over-the-counter drugs. If possible, do this 10 to 14 days before the procedure or as directed. You may also need to stop taking vitamin E.

  • If you take blood thinners, ask your caregiver when you should stop taking them.

  • You may need a stool-softening medicine a few days before the procedure.

  • Stop smoking 2 weeks before the procedure if you smoke. Smoking can slow down the healing process.

  • The day before the procedure, eat only a light dinner. Do not eat or drink anything for at least 8 hours before the procedure. Ask if it is okay to take any needed medicines with a sip of water.

  • You may talk with the person who will be in charge of the anesthetic medicine during the procedure.

  • Arrive at least 1 to 2 hours before the procedure or as directed.

PROCEDURE

  • Small monitors will be put on your body. They are used to check your heart, blood pressure, and oxygen level.

  • An intravenous (IV) access tube will be inserted in your vein. Medicine will be able to flow directly into your body through the IV.

  • You might be given a medicine to help you relax (sedative).

  • You will be given a medicine that makes you sleep (general anesthetic).

  • Your back will be cleaned with a special solution to kill germs on the skin.

  • Once you are asleep, the surgeon will make a small incision in the middle of your lower back. It is often just 1 to 2 inches long.

  • Muscles in the back are not cut. They are moved to the side.

  • Often, a small piece of bone needs to be removed. This creates a better "window" so the surgeon can see the herniated disk.

  • The surgeon uses a microscope to check the disk and nerves near it.

  • The part of the disk that is causing problems is removed.

  • The area under the skin is closed with stitches. In time, these will go away on their own.

  • The skin is closed with small stitches (sutures) or staples.

  • A small bandage (dressing) is put over the incision.

  • The procedure usually takes about 1 hour.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked every so often.

  • Some pain is normal after this surgery. You will probably be given pain medicine while in the recovery area.

  • You may be able to go home the same day as the surgery. Once you get up and start walking, you will be able to go home. Sometimes, an overnight stay is needed.