A Microdiscectomy is a surgical procedure aimed at relieving pain, particularly leg pain and other symptoms caused by a herniated disc pressing on a nerve in the spine. Here’s a step-by-step overview of what is involved in the procedure:

What happens during a Microdiscectomy?

Preparation

• You will be admitted to hospital on the day of surgery and will be required to fast prior to the procedure. The specific fasting time will be provided by your anaesthetist.
• Anaesthesia:  You’ll be given general anesthaesia, meaning you’ll be asleep and pain-free during the procedure.
• A urinary catheter may be inserted during the procedure if longer procedural time is anticipated. Antibiotics are also administered to reduce the risk of infection.

Positioning

• You’ll be positioned face down on the operating table, with your abdomen supported to maintain the natural curve of your spine. This position helps A/Prof Buckland access the herniated disc.

Incision

• Small Incision: A/Prof Buckland makes a small incision, usually 3 to 4 cm long, in the lower back directly over the affected disc. This is much smaller than the incisions used in traditional open surgery.

Accessing the Spine

• Muscle Retraction: A/Prof Buckland uses specialised instruments to gently move the muscles of the back aside without cutting them. This technique helps minimize muscle damage and aids in a quicker recovery.
• Removal of Bone (Laminotomy): In most cases, a small part of the bone over the nerve (called the lamina), as well as ligament may be removed to give A/Prof Buckland better access to the disc and nerve and to ensure the nerve is appropriately freed of pressure. This step is called a laminotomy.

Removing the Herniated Disc Material

• Using a microscope for enhanced visibility (hence the term “micro” in microdiscectomy), A/Prof Buckland carefully locates the herniated portion of the disc.
• The herniated portion of the disc pressing on the nerve is then removed. The remaining good part of the disc is left intact to preserve its cushioning effect.

Closing the Incision

• Once the herniated disc material is removed, the instruments are withdrawn, and the muscles are allowed to return to their normal position.
• The incision is then closed with dissolvable sutures, and a sterile bandage is applied.

Recovery Room

• After the surgery, you’ll be taken to a recovery room, where you’ll be monitored as you wake up from anaesthesia.
• Pain relief will be managed, and you may be asked to walk a short distance soon after the surgery to start your recovery.

Postoperative Care and Recovery

• Hospital Stay: Microdiscectomy is often performed as an outpatient procedure, meaning you might go home the same day or stay overnight.
• Pain Management: You may be prescribed pain medication to treat the incisional pain and advised to avoid heavy lifting, twisting, or bending for 8 weeks. When you awake from the procedure, the leg pain will usually have substantially improved.
• Physiotherapy: A tailored physiotherapy program may be recommended to strengthen the back muscles, improve flexibility, and reduce the risk of future injuries.
• Follow-up: You’ll have follow-up appointments to monitor your recovery and ensure that the symptoms have improved.

Most people experience significant relief from leg pain (sciatica) almost immediately after the surgery. However, full recovery might take several weeks, during which you’ll gradually return to your normal activities.

Risks and Complications

• As with any surgery, there are potential risks, including infection, bleeding, spinal fluid leak, nerve injury, or recurrence of the disc herniation. However, microdiscectomy is generally considered safe and effective, with a high success rate.

To learn more about A/Prof Buckland’s patient-reported outcomes of lumbar microdiscectomy surgery, click the button below.