What is Microdiscectomy

Microdiscectomy is a procedure to remove a herniated disk. Disks are oval-shaped layers of connective tissue (cartilage) in between the bones in the spinal column (vertebrae). Disks prevent vertebrae from rubbing together.

A disk can tear and bulge outward (herniate). This puts pressure on nerves that are near the spine. The goal of this procedure is to treat pain, weakness, and numbness in the lower body that are caused by a herniated disk.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.
• Any recent symptoms of colds or infections.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs, such as nerves near the spine.
• Spinal fluid leakage.
• Blood clots.
• Return (recurrence) of the herniated disk.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Your health care provider will do a physical exam.
• You will have blood and urine samples taken.
• You may also have tests, such as:
  • X-rays.
  • MRI.
  • CT scan.
  • Myelogram.
  • Electrocardiogram (ECG).
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• A small surgical cut (incision) will be made in your back, above your herniated disk.
• Your back muscles will be moved aside so the surgeon can see your vertebrae.
• A small piece of bone may be removed so the surgeon can see your herniated disk.
• The surgeon will use a microscope to look at the disk and the nerves that are near it.
• The surgeon will remove the part of your disk that is causing problems.
• Your back muscles will be moved back into place.
• Your incision may be closed with stitches (sutures) or skin glue.
• A bandage (dressing) will be put over your incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will be given pain medicines as needed.
• You may continue to receive fluids and medicines through an IV.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may have to wear compression stockings. These stockings help prevent blood clots and reduce swelling in your legs.

Care After Microdiscectomy

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions.

Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain and stiffness in your back.
• Pain and redness around your surgical cut (incision).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Keep your incision clean and dry. Do not take baths, swim, or use a hot tub until your health care provider approves.
• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Check your incision and the surrounding area every day for redness, swelling, and leaking fluid.

Physical Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you. Rest and protect your back as much as possible.
• Do not lift anything that is heavier than 8 lb (3.6 kg) or the weight limit that your health care provider tells you until he or she says that it is safe. Avoid lifting anything over your head.
• Avoid twisting and bending at the waist until your health care provider approves.
• Avoid pushing and pulling motions.
• Avoid sitting or lying down in the same position for long periods of time.
• Ask your health care provider what kinds of exercise you can do to make your back stronger. Do not begin exercising until told by your health care provider.

General instructions

• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider and, if necessary, your physical therapist. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not get better with medicine.
• Your legs or your feet become painful or swollen.
• You have redness, swelling, or pain at the site of your incision.
• You have fluid, blood, or pus coming from your incision.
• You vomit or feel nauseous.
• You have difficulty controlling urination or bowel movements.
• You have a fever.

Get help right away if:

• You have severe pain.
• You have trouble breathing.
• You develop a cough.
• You have chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.