Microsurgical discectomy is for those whose severe lower back or leg pain due to a herniated disc has not responded to more conservative treatment methods after at least 6-12 weeks. Patients typically have failed to respond to home treatment. Patients typically only have a single herniated disc, rather than multiple.
Candidates who have severe back pain without an identifiable cause would not be helped by spinal surgery. Candidates who have yet to try more conservative treatment methods such as physical therapy, chiropractics, epidural injections and medication should try more conservative treatment before deciding upon lumbar decompression surgery. Patients with multiple herniated discs may be more suited to spinal fusion.
Like other surgeries, microsurgical discectomy requires certain general surgery procedures such as preoperative blood testing, and cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery,.
Immediately after microsurgical discectomy, you should be able to walk, but will need to restrict bending at the waist, lifting and twisting in the early postoperative period. You will be given pain medication to take home. You should also avoid sitting in the same position for more than hour in the first few weeks postoperative. Physical therapy is typically required as soon as initial pain and swelling has subsided in order to improve range of motion and ensure proper healing. Most patients will not return to week for at least 2 weeks, and many patients with active jobs or who participate in heavy athletic activity are able to return 4-6 weeks after surgery.
As with any surgery, there is a risk of complications related to bleeding, infection or adverse reactions to anesthesia. Other known complications include injury to nerves and blood vessels. Complications specific to microsurgical discectomy include dural tear (cerebrospinal fluid leak), and bowel/bladder incompetence.