Know More About the Microdiscectomy Procedure

Microdiscectomy or microdiscectomy is spinal surgery to treat pinched nerves. On operation this, the surgeon will remove the pads on the spine to relieve pressure on the spinal nerves, so the symptoms can subside.

Not all pinched nerves (hernia nucleus pulposus) need surgery. There are patients whose condition improves after undergoing treatment with drugs and physiotherapy. In fact, most people with herniated nucleus pulposus symptoms can heal on their own after a few weeks.

Doctors generally only advise patients to do microdiscectomy if symptoms do not subside after undergoing treatment and physiotherapy for more than 3 months. A microdiscectomy is performed to prevent the symptoms from getting worse due to a pinched nerve.

Goals and Indications for Microdiscectomy

Symptoms of a herniated nucleus pulposus may include pain, tingling, or weakness in the affected area. If it occurs in the neck, the pain may radiate to the shoulder and arm.

Meanwhile, if the hernia nucleus pulposus occurs in the lower back, the pain will radiate to the buttocks, thighs, and calves. This radiating pain is known as sciatica. The pain will be felt when the sufferer coughs, sneezes, or moves the body to a certain position.

Doctors can treat a pinched nerve with drugs and physiotherapy. Microdiscectomy is only performed if the patient has been in pain for more than 3 months and non-surgical treatment has been unsuccessful.

In addition to sciatica that does not improve, a microdiscectomy may also be performed when symptoms of a herniated nucleus pulposus cause:

Numbness or muscle weakness
Difficulty standing or walking
Loss of control of urination and bowel movements

Warning Before Doing Microdiscectomy

Microdiscectomy is generally safe to perform. However, the doctor may recommend further surgical procedures if the patient is found to have multiple pinched nerves. In addition, there is a possibility that the pinched nerve and pain in the affected area will return after surgery.

Go to the hospital emergency room immediately, either before or after surgery, if a pinched nerve causes any of the following:

Symptoms of a pinched nerve get worse and interfere with daily activities.
Patients with bedwetting or difficulty urinating, or unable to control bowel movements.
Saddle anesthesia or ongoing numbness on the inside of the thigh, back of the leg, and the area around the anus.

Preparation Before Microdiscectomy

Before the microdiscectomy procedure, there are several things that the patient needs to do, namely:

Undergo a health check (check-up), either a medical examination from a general practitioner or a specialist who treats other conditions the patient has, for example an examination by a cardiologist.
Stop smoking since a few months before surgery, to prevent postoperative complications such as infection or slow wound healing.
Prepare blood from donors, to be used as backup blood in case of heavy bleeding.
Stop using certain medications, such as aspirin or non-steroidal anti-inflammatory drugs, because they can cause bleeding and block the action of the anesthetic.
Patients also need to tell their doctor if they are using certain herbal medicines or supplements while undergoing the examination.

The day before the microdiscectomy procedure, the patient needs to be hospitalized so that doctors and nurses can prepare all the necessities. Prior to surgery, the anesthesiologist will also look at the patient's medical history and perform a physical examination to determine the type of anesthetic to be used.

There are 2 types of anesthesia (anaesthesia) that can be used in the microdiscectomy procedure, namely:

General (general) anesthesia, which is an anesthetic that will put the patient to sleep during the microdiscectomy procedure.
Half body anesthesia, which is an anesthetic that keeps the patient conscious, but half of his body (from the waist down) will be numb.

Do not forget to inform the anesthesiologist about the disease or medical condition you have. Also tell the anesthesiologist if you or your family have allergies or have experienced certain problems related to anesthetic drugs.

Procedure and Action Microdiscectomy

Prior to surgery, the patient will lie in a prone position. After that, the doctor will give you an anesthetic. The anesthesiologist and medical team will monitor the function of the patient's vital organs during the procedure, including heart rate and blood pressure.

It usually takes 1-2 hours for the microdiscectomy procedure to be completed. The following will describe the steps performed during microdiscectomy surgery:

The neurosurgeon or orthopedic doctor will make a small incision in the patient's back, just behind the disc or pad that is problematic. During surgery, the doctor will use a special X-ray device to confirm the location of the affected nerves
After the incision is made, the surgeon will insert a wire-shaped device into the affected spinal cord, then the doctor will insert a larger metal tube down the direction of the wire.
Next, a metal tube that is getting bigger and bigger will be inserted right around the previous tube. This action is done to shift body tissue to reach the spine.
After successfully reaching the inside of the spine, the doctor will remove all the wires and tubes, then with special tools for microdiscectomy surgery, including a lamp and microscope, the surgeon will remove the part of the pad that is holding the nerve.
Once deemed sufficient, surgical instruments will be removed from the patient's body, then the doctor will close the incision with stitches and apply a bandage to cover the patient's wound.

Recovery After Microdiscectomy

After surgery, patients are allowed to go home 24 hours after surgery. During the recovery period the patient will be required to follow a physiotherapy program. Physiotherapy is done to increase the strength and flexibility of the muscles around the spine.

For the time being, the patient also needs to avoid some activities, such as sitting too long, lifting heavy weights, driving vehicles, and bending over. The doctor will also ask the patient to wear a corset or spinal support for some time after surgery.

Most patients who undergo microdiscectomy are able to return to their activities after 2 weeks. However, it takes about 1.5 months to heal completely.

Your doctor may prescribe pain medication if the scar is painful. The pain felt by the patient is usually milder than the pain from a pinched nerve before surgery.

During the recovery period, the surgical wound will ooze fluid. This condition is normal, but consult a doctor immediately if fever, severe pain, or pus comes out of the surgical scar.