Spine Surgery: Microdiscectomy

When a patient has confirmed disc pathology, many different surgical procedures may be recommended. This is often diagnosed through a battery of examinations performed by the doctor and/or diagnostic imaging such as an X-ray or MRI.

A microdiscectomy is a surgical procedure to treat a herniated or bulging disc in the spine, either in the cervical spine (neck) or lumbar spine (lower back). When an intervertebral disc herniates or bulges, it can put pressure on nearby nerves, causing pain, weakness, or numbness in the back, legs, or feet. This often comes in the form of sciatica.

During a microdiscectomy, the surgeon makes an incision big enough to fit surgical instruments into the treated area. Specialized surgical instruments and a microscope are used to carefully remove the portion of the herniated disc that is pressing on the nerve root. By removing this part of the disc, pressure on the nerve is relieved, often alleviating the associated symptoms.

However, the patient must understand the specific anatomy of the disc that gives it strength. Cartilaginous rings (annulus) support the inner gel-like fluid (nucleus). If damaged, the annulus can no longer fully support the nucleus. When this occurs, the disc begins to bulge, putting excess pressure on the remaining annular rings.

The term “micro” in microdiscectomy refers to using a microscope or other magnifying devices that allow the surgeon to see and operate on the affected spinal area more precisely. This minimally invasive approach typically results in less tissue damage, reduced blood loss, and faster recovery than traditional open spine surgery such as a laminectomy or fusion.

Microdiscectomy is considered a relatively safe and effective treatment option for herniated discs that haven’t responded to conservative treatments like medication or physical therapy. However, like any surgical procedure, it carries some risks, including infection, nerve damage, or recurrence of the herniation. It’s important for patients to discuss the potential benefits and risks of microdiscectomy with their healthcare provider before undergoing the procedure.

While a microdiscectomy can be a short-term solution for spine pain and associated radiculopathies like sciatica, there is little evidence that it affects the long-term degeneration of the disc intself. Intervertebral disc issues like bulging and herniated discs can be degenerative in nature. There is undue stresses being placed on the spine which is why the structural mechanism of the disc starts to fail. Unless these abnormal mechanical stresses are corrected, these intervertebral discs will continue to bulge and/or herniated regardless of surgical intervention.

Non-surgical spinal decompression, according to medical literature, has shown to be the most effective at treating disc injuries. Studies coming out of Johns Hopkins, Harvard, Stanford, and the Mayo Clinic have shown the effectiveness of this non-invasive treatment. The McClure Study is the largest research paper to date which shows a success rate of non-surgical spinal decompression of 88-92%.

While some cases warrant surgical intervention, many disc injuries can be effectively treated with less invasive means.

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