Microdiscectomy For Sciatic Nerve Pain Relief

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Microdiscectomy Surgery To Relieve Sciatica Pain

When a disc in the spine slips, or gets herniated, a person typically experiences numbness, pain and a tingling feeling in the back and legs. All of this together cause great discomfort to the sufferer, and the most popular option is surgery. Doctors usually recommend lumbar microdiscectomy, a medical procedure which involves the removal of some portion of the nucleus pulposus. Some part of this nucleus pulposus slips and causes the pain, and therefore its removal is only way to immediate relief.

Any encroachment on your nerve root will lead to compression, and is one of the primary reasons for pain in the legs. Lumbar microdiscectomy offers immediate relief from pain, but it may actually be some months before the nerve root heals entirely. The medical procedure is aimed at treating lower back and leg pain, however, further studies have proven that the operation is more effective for treatment of the legs than it is for the lower back.


How to Differentiate Between a Bulging and Herniated Disc

Although the terms bulging and herniated are commonly relatively used, these are significantly different from each other. Let us first see what a bulging disc is. Ideally, the middle of a disc contains nucleus pulposus. When a small projection erupts from within the pulposus and forces its way into the spinal canal, this is usually a bulging disc. A characteristic feature is the outer ring of the disc, referred to as annulus fibrosus. While this ring remains unbroken in case of a bulging disc, a herniated disc typically bursts through it when pushing the spinal canal. The encroachment of the nerve root in the process then leads to the pain in the sufferer’s lower back and legs.

Bulging disc spin problems

How to Know if You Require Lumbar Microdiscectomy

Doctors usually recommend microdiscectomy surgery to patients suffering from herniated discs who are unable to carry on with their routine duties because of the pain.

Generally, a doctor will want to postpone surgical treatment for as long as possible in this case. Leg pain caused due to a herniated disc can heal, and it may take 6-12 weeks until healing initiates. A doctor waits for a certain time period to see if the healing starts and this is until the patient is capable of bearing the pain and can carry on with his duties adequately.

However, if the use of non-surgical treatment fails, the doctor may suggest a microdiscectomy to relax the additional pressure exerted on the nerve root. This also relieves the patient of the pain and initiates the healing process. Spinal surgery is only essential in cases where the patient is suffering from progressive neurological insufficiency or incontinence in the bladder/bowel. Additionally, if the leg pain becomes acute, your doctor may also suggest operating your back.

Predictably, microdiscectomy is suggested to patients suffering from:

•    Acute leg pain for a minimum of six weeks

•    Pain which could not relieved with the use of conservative treatment options

Unfortunately, delaying the surgery for a long time will only render it useless. A spine surgery carried out after 3-6 months will have no approving results, and therefore if it has to be done, one should have it done soon enough.

The Microdiscectomy Process Explained

The surgical treatment is carried out with by making a small incision on the midline of the patient’s lower back. The cut made is small, and no longer than 1 ½ inches.

•    The procedure primary targets the removal of the back muscles, biologically known as erector spinae from the lamina (or bony arch) of the spine. The removal is possible because these muscles run vertically, and therefore allow removal rather than cutting.

•    The next step involves the removal of a membrane. This lies above the nerve roots, and the surgeon may decide to use operating glasses or a microscope to analyze the nerve root.

•    The surgery usually results in the removal of a relatively smaller part of the inside facet joint. This allows the doctors to have comfortable access to the patient’s nerve roots.

•    The final step of the surgery is the removal of the disc material by slightly moving the nerve root.

Lumbar Microdiscectomy – How Effective It Is

Statistics show that microdiscectomy has successfully treated leg and lower back pain in about 90% of the cases. Although tests and general results have shown that a patient experiences pain relief pretty soon after the surgery, there have been some rare instances where it took up to 8 weeks for the pain to pass. However, the success rate of the surgery dramatically decreases for patients suffering from herniated discs for a long time. In addition, such patients are also made aware of the side effects of the surgery – tingling feeling in the back and tolerable residual weakness in the body.

Microdiscectomy for herniated disc

To conclude the effects of lumbar microdiscectomy, the National University of Health Sciences carried out a study with the following details.

Objective: The study intends to compare the clinical efficiency of spinal management with microdiscectomy done in patients suffering from sciatica and herniated lumbar discs.

Methods: The study comprised of a hundred and twenty patients, each of them having come with an elective referral. Also included in these was a group of 40 patients who fulfilled the inclusion criteria

Results: The results showed effective results of the treatment in both groups of patients. Even after a year, follow-up analysis did not come up with any negative results. There was, however, an issue with 3 patients who had cross over surgeries (from surgery to spinal management), and no improvement was observed in their case. Eight other patients who had undergone the same surgery showed equal improvements as their other counterparts.

Conclusion: It was concluded that about 60% of patients suffering from sciatica who had no positive effects from medication responded equally to spinal manipulation as they would have done to surgical procedures. The remaining 40% were observed to have undergone improvement with subsequent surgical interventions. The studies also concluded that sufferers of symptomatic LDH who could benefit from medications could respond well to spinal management and then surgery.

The Limitations of Lumbar Microdiscectomy

One of the most popular drawbacks of this procedure is the slight loss of strength of the affected disc. Technically, when a disc in a patient’s back gets herniated, the result is hole that forms surrounding the outer ring. Now, this hole has to be further enlarged for the surgeon to successfully carry out the operation, and unfortunately, there is no possible way to restore the damage done to disc. And although the surgery will relieve you of leg and back pain, you must know that you will have always a weak disc which is prone to additional damage if increased stress in exerted on your back.


Post Surgical Care

It is typical for a patient to experience back pain up to 48 hours of the surgery. However, application of ice can considerably reduce the pain. Start with filling a small plastic bag with ice and apply it for about twenty minutes. Take a break for about a couple of hours and repeat the process. However, ensure that the ice is not applied directly to the skin since it increases the possibilities of ice burns.

Health experts suggest the alternate use of ice and hot packs to give relief to the patient if the pain fails to subside after 48 hours.

Medications to Use after Surgery

Your doctor will suggest and prescribe the required medication after the operation and while you are still in the health care facility. Doctors usually suggest oral medications for anywhere between 1-4 weeks, depending on the type of procedure being performed and how your body responds to the drugs.

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