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Microdiscectomy in New Jersey

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W

hen a slipped disc puts pressure on a spinal nerve, a patient may just notice pain in their lower back or neck. Nerve compression, however, can also lead to radiating pain, numbness, and muscle weakness. Microdiscectomy surgery can be a good fit for treating a herniated disc when less invasive treatments do not offer relief. The board-certified surgeons at Centers for Neurosurgery, Spine & Orthopedics (CNSO) in northern New Jersey are well-versed in performing this procedure. Learn more about microdiscectomy from CNSO.

What Is Microdiscectomy?

Microdiscectomy is a minimally invasive surgical procedure used to treat a herniated disc in the spine by removing a portion of the disc. A form of spinal decompression surgery, microdiscectomy relieves back or neck pain caused by the impingement of a herniated intervertebral disc on the spinal nerves.

Understanding Spinal Disc Herniation

The spinal column is made up of a series of bones called vertebrae that run from the base of the skull to the tailbone. Between the vertebrae are discs that act as shock absorbers and help the spine twist and bend. These intervertebral discs have a jelly-like nucleus and a stiff outer ring of cartilage known as the annulus. Over time, the outer layer can weaken and crack, causing the nucleus to push out. The leaked nucleus material can press against nearby spinal nerves, causing irritation and inflammation.

A herniated disc can be caused by a repetitive stress injury or a sudden strain, or it may simply be the result of aging. Symptoms of spinal disc herniation can include:

  • Acute neck pain or back pain
  • Chronic neck or back pain
  • Pain, numbness, and weakness on one side of the body
  • Pain that radiates into an arm or leg
  • Pain that is worse after standing or sitting for a while
  • Tingling, aching, or pins-and-needles sensations
  • Muscle weakness in a hand, arm, leg, or foot

To diagnose a herniated disc, a physician will typically perform a physical exam, as well as review the patient’s symptoms and medical history. They may test nerve function and muscle strength. Imaging tests, such as a CT scan or MRI, can help confirm a diagnosis, as well as an electromyography (EMG) test that assesses nerve damage.

Conservative Treatments for Disc Herniation

CNSO takes a conservative approach to pain management and treatment throughout the patient journey, recommending spine surgery only when necessary. Often, a herniated disc can be treated through non-invasive options such as:
  • Physical therapy: A certified physical therapist can perform manual release techniques and teach the patient stretches and exercises that offer symptom relief.
  • Medications: Over-the-counter medications can reduce pain and inflammation caused by muscle spasms around the herniated disc.
  • Epidural steroid injection: An image-guided injection of steroid medication can decrease inflammation around the nerve tissue.

The Advantages of Microdiscectomy

For herniated disc pain and nerve compression that does not resolve with conservative care, surgery may be an option. The advantages of microdiscectomy include:
  • Smaller incision: Because microdiscectomy uses minimally invasive techniques, the procedure can be performed using a smaller incision than traditional back surgery.
  • Shorter hospital stay: After microdiscectomy, a patient may be able to go home the same day or just stay a night or two at the hospital.
  • Faster recovery: Minimally invasive surgery means less bleeding, pain, and swelling at the incision site, helping patients get back on their feet faster.

Preparing for Microdiscectomy Surgery

Before microdiscectomy surgery at CNSO, the surgical team will walk the patient through each step of the process so they know what to expect before, during, and after surgery. They will answer any questions the patient may have and perform additional imaging tests to help create a surgical plan. They also will give pre-operative instructions, such as avoiding eating or drinking the night before surgery.

The Microdiscectomy Procedure

Microdiscectomy usually is performed under general anesthesia. During the procedure, the neurosurgeon uses fluoroscopy to visualize the spine anatomy. After making a very small incision near the affected disc and separating the muscle tissue to access the spinal column, they will remove the damaged tissue with a specialized instrument. Removing the tissue alleviates pressure on the affected nerves. Once the procedure is complete, the neurosurgeon will close the incision site with sutures.

Potential Risks and Complications

Even minimally invasive surgeries carry the possibility of complications or risks. These could include an adverse reaction to anesthesia medication or damage to the surrounding tissue during surgery. While these scenarios are unlikely, the medical team at CNSO has a plan in place to treat any complications that arise during surgery. Success rates for microdiscectomy are generally high; one meta-analysis of over 39,000 patients found that 84.3% reported good or excellent results. The neurosurgeon will discuss the potential risks and benefits of microdiscectomy with the patient.

Recovery and Postoperative Care

Patients are monitored immediately following surgery. After being discharged from the hospital, most patients can get up and walk around after a day of rest. The incision site should be kept clean and dry, with bandaging changed daily. Patients will need to avoid bending, twisting, and lifting for about two weeks after surgery. Follow-up appointments will track the patient’s rehabilitation and recovery. Most patients will have physical therapy appointments as part of their recovery to strengthen the muscles around the spine, improve flexibility, and help minimize post-operative pain.

Returning to Daily Activities

Some patients experience symptom relief right after microdiscectomy; others notice an improvement over several days or weeks. In general, patients can expect a gradual return to work and exercise. It can take about eight weeks to get back to normal activities after microdiscectomy. Through physical therapy, patients will learn the proper posture, exercises, and stretches to support long-term spinal health. Other lifestyle changes, such as diet and exercise, may be recommended as part of the patient’s rehabilitation care.

Comparing Microdiscectomy to Other Spinal Surgeries

Microdiscectomy is a less invasive alternative to open discectomy. An open approach may be needed, however, for patients who have issues such as arthritis of the spine. With a slightly larger incision, open discectomy allows for more extensive decompression treatment. In some cases, spinal fusion surgery may be performed along with discectomy. Fusion surgery permanently joins two or more vertebrae so there is no movement between the bones. This approach may be used in cases of severe spinal instability. During the procedure, a neurosurgeon may use a bone graft or stabilization hardware such as metal plates or screws to fuse the vertebrae.

Frequently Asked Questions About Microdiscectomy

Some frequently asked questions regarding microdiscectomy include:

How Long Does the Microdiscectomy Procedure Take?

The surgical procedure often takes just 30 to 60 minutes, but additional time is required to give the patient anesthesia beforehand and monitor them afterward. If a microdiscectomy is being performed along with another procedure, such as a laminectomy, the patient will be in surgery longer.

Is Microdiscectomy Always Suitable for Disc Herniation?

While microdiscectomy can relieve back or neck pain caused by a herniated disc, it may not be necessary for symptom relief. Many patients with a herniated or slipped disc can be effectively treated with conservative care such as medications and physical therapy.

What Can I Expect During the Recovery Period?

Patients will need to take time away from work following surgery. Most patients feel well enough to go back to work after two weeks, but they may have activity restrictions for six weeks or more. Patients should expect to begin physical therapy two or three weeks after surgery.

Will I Experience Pain After the Surgery?

Some pain or swelling at the incision site is common. Most patients can manage any post-operative discomfort with non-opioid pain medication or muscle relaxants.

Can I Resume Sports and Physical Activities After Microdiscectomy?

While it is important to stretch and move the body during recovery from surgery, patients will need to avoid sports and strenuous exercise for a few weeks. They should also avoid lifting any heavy items.

Trust CNSO for Microdiscectomy

At CNSO, patients can receive expert treatment for a herniated or slipped disc. Offering comprehensive back and spine care, CNSO’s team includes neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. CNSO has multiple convenient locations throughout northern New Jersey so patients can get the best care close to home. To learn more about microdiscectomy surgery or to schedule a consultation, contact CNSO today.
When spinal discs become weakened they can push against the nerve or spinal cord, which causes the elastic ring to extend, thus inflicting pain.
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