Our spinal cords have small cushion-like disks that act like shock absorbers. These discs nestle between vertebrae to absorb the force on the spine when we jump, run, walk, et cetera. Unfortunately, age, excess weight, or everyday wear and tear can lead to a condition known as herniated discs or disc herniation. Traumatic injuries and playing sports can also result in disc herniation.
Disc herniation is prevalent. It generally occurs in the lumbar spine and neck region and can be characterized by severe back pain. Fortunately, our neuro-interventional surgeons at Dr. George Rappard's Practice have you covered.
We not only consider our patients' specific signs and symptoms when developing a personalized treatment plan but also accompany our skills and expertise with compassion and sensitivity. Call us for a consultation if you are experiencing back or neck pain you suspect or believe results from a herniated disc and seek to undergo treatment in Los Angeles, CA.
What is Minimally Invasive Herniated Disc Surgery?
Minimally invasive herniated disc surgery is a procedure to relieve symptoms caused by disc herniation. As mentioned, discs are parts of spongy, cartilaginous material that act as cushions between spinal vertebrae. The spinal cord has twenty-five discs, vital for structural support and ease of motion. A disc herniation happens when the matter at the center of the disc leaks out to and beyond the outer disk layer.
Some individuals may suffer a disk herniation without knowing it. But when the disc material compresses on spinal nerves, it can result in severe pain (which can extend down a single or both legs and arms, as in the case of sciatica) and other symptoms like difficulty with repeated movements, tingling, numbness, and muscle weakness, impacting an individual's quality of life.
Most people can recover from disc herniation after undergoing only conservative treatments like cortisone injections, physiotherapy, and oral medications. A doctor recommends minimally invasive herniated disc surgery only if traditional treatment methods have been used for at least six to twelve weeks and have been unsuccessful. Surgery is conducted to ease the pressure exerted on the spinal nerves by extracting the disc material. Muscle weakness is sometimes a reason to undergo the surgical procedure sooner.
Minimally invasive herniated disc surgery is sometimes known as microdiscectomy since it involves making only a tiny incision and using surgical loupes or a microscope to magnify the injury site. Additionally, the surgeon uses smaller instruments and tools to navigate the restricted spinal space.
Since it uses a tiny incision and smaller instruments, this surgical procedure is less traumatic than open discectomy (open discectomy refers to a process that allows a surgeon several options during an intricate procedure; the treatment usually necessitates a longer stay in the hospital than other techniques and can involve an extended period of recovery).
Minimally invasive herniated disc surgery is a form of spine decompression surgery. Sometimes, the word microdecompression (describing the surgical extraction of any ligament or bone pressing on a nerve) is also used to refer to the procedure. Nevertheless, minimally invasive herniated disc surgery particularly refers to extracting the part of the herniated disk tissue causing the pain and other symptoms.
When to See a Doctor
Consult your doctor when you first experience pain. They will likely recommend physiotherapy and other nonsurgical treatments during the initial few weeks. The doctor may need you to do a scan before recommending a steroid injection and will recommend surgery if only other methods fail.
Additionally, you want to speak with your doctor if you have back pain and are experiencing these symptoms:
- Pain that worsens at night.
- Swelling in the back.
- Pain that refuses to ease even after taking pain relievers.
- Pain that continues after one month.
- Unexplained weight loss.
Seek urgent medical care if you develop the following signs and symptoms:
- Loss of bladder or bowel control.
- Lost sensation in one or both legs.
- Numbness around the genitals and buttocks.
- Muscle weakness.
- Unexpected and extreme leg or back pain.
- Any of the above symptoms develop after a severe accident.
The Procedure: Before, During, and After
The minimally invasive herniated disc surgery procedure is explained in these steps:
A preoperative evaluation usually occurs a couple of days before the actual procedure. Your doctor will do a general health examination to ensure you are an ideal candidate for the procedure. They could also conduct blood tests.
At times, MRI or X-ray scanning of the spinal cord is required to obtain the latest images of the affected areas. This primarily happens if some time has passed since the initial scanning that disclosed the herniation was done.
Before The Procedure
Most people with disk herniation do not need to undergo surgery. Conservative treatments can suffice. However, if you have attempted and been unsuccessful at traditional treatment methods and your doctor has recommended minimally invasive herniated disc surgery, you want to prep for the process. Your doctor will provide you with details about preparing for the surgery.
The doctor will likely advise you to avoid drinking or eating anything except water the night before the surgical procedure. They will require you to drink only a small amount of water during the last hour before your surgery. When showering on the day of the treatment, some doctors will advise you to use a special anti-bacterial scrub on your body to minimize the chances of infections during surgery. Showering is also good since it might be some time before you have another opportunity to shower.
Once you reach the surgical center or hospital, the doctor may ask you to remove your clothing (you will be given a hospital gown), jewelry, and makeup. They will measure your vital signs, then start an IV (intravenous) line and bring you to the operating room. Your anesthesiologist, nurses, and surgeon will be present. The anesthesiologist will administer anesthesia, and the surgeon can begin the surgery.
During The Procedure
The anesthesiologist will administer general anesthesia so you remain asleep during surgery. After being anesthetized on the operating table, the surgeon can use one of these techniques to access the compressed spinal nerves and herniated disc: endoscopic, tubular, or midline microdiscectomy.
- Tubular microdiscectomy involves the surgeon inserting a series of dilators or small tubes via a small cut to form a corridor via the muscle in which to operate, thus causing minimal disruption to the surrounding tissues.
- Endoscopic microdiscectomy (also called microendoscopic discectomy) entails the surgeon making an even smaller cut and using other miniaturized instruments and a camera. This technique also entails less disruption of the neighboring tissues.
- Midline microdiscectomy involves the surgeon making a small vertical incision (usually one to two inches) in your lumbar spine at the herniated disc level, lifting the neighboring muscles off the spine, and using tools to hold apart the tissue and muscle layers during the process.
Irrespective of the surgeon's technique, there is only one goal: to extract the disk fragment and any ligament or bone pressing on the nerves.
Once the surgeon has accessed the herniated disc and compressed nerves, they will use a microscope with a light to check the affected disc. They might also do another X-ray to examine the site of the herniation.
The surgeon might extract a slight portion of the spinal bone to uncover the root of the nerves. After that, they will use special tools to remove the herniated or fragmented disc tissue, relieving pressure on the spinal nerves. The surgeon will be monitoring your vital signs during the entire process.
Once the nerves have decompressed, the muscles shift to their initial position. The surgeon will remove the surgical instruments and tools and suture the incision. They will bring you to the recovery room, where you will remain until you wake from anesthesia.
On average, the minimally invasive herniated disc surgical procedure takes thirty minutes to one hour to complete. However, since patients are usually under general anesthesia and must spend some time in the recovery room after the surgery for monitoring, the overall time often extends to approximately two hours.
After The Procedure
You might feel pain right after you awake from the surgery and the general anesthesia wears down, although a nurse will give you pain relievers to help alleviate the pain. The nurse will routinely check your blood pressure, pulse rate, and other vital signs. A wound drain may be necessary, although it does not always happen.
Before being discharged, your doctor will likely check that you can use the toilet and ensure you have no sign of the cerebrospinal fluid leaking. You will probably be discharged from the hospital or surgical center later the same day, or you may stay there overnight.
Anticipate resting for a couple of days after reaching home. Your doctor will prescribe pain medication like opioids, though most patients will not need pain medication for long. Once you have rested for three or two days, your doctor will instruct you to increase your activity level gradually.
During your immediate postoperative period, avoid sitting slouched or bending. These activities can pull on the incision or cause disc re-herniation. Avoid so much bending and sit in supportive chairs.
You can also benefit from physiotherapy to increase your activity level after minimally invasive herniated disc surgery. Your physiotherapist can evaluate your movements and condition and prescribe various exercises to improve your function, strength, flexibility, and range of motion. The physiotherapist can also assist you in attaining and maintaining appropriate posture to avoid disc re-herniation.
Most patients expect to move normally in about two weeks to one month after the surgical procedure, with full recovery taking two months. Some patients might take quite a while. Ensure to speak with your doctor about what you can expect.
Whereas disc herniation can occur in virtually any area in the spinal cord, lumbar herniated disc surgery—surgery in the lower back—is the most prevalent site for this procedure.
Risks and Complications of Minimally Invasive Herniated Disc Surgery
Every surgical procedure has risks. The risks associated with minimally invasive herniated disc surgery can occur because of the direct impact during the surgery. These risks are rare, but when they occur, they include:
- A tear in the dura (the tissue surrounding the spinal nerves). The surgeon can repair this with a patch made of collagen or a suture.
- Nerve damage or injury.
- Recurring disc herniations.
- Pain at the incision site.
- Blood clots.
- Blood vessel injury.
- Leaking of spinal fluid, which might cause headaches and other problems.
- Complications from anesthesia.
- Insufficient relief of back pain.
Despite the potential risks mentioned above, research shows that minimally invasive herniated disc surgery is safe, with rarely occurring severe complications.
Risks and complications vary across patients based on overall health, age, and other factors. Having an experienced surgeon conduct the procedure can assist in minimizing them. Speak with your doctor about the anticipated risks or complications of the process to make an informed decision about the surgery and whether it suits you.
Benefits of Minimally Invasive Herniated Disc Surgery
Minimally invasive herniated disc surgery has several benefits. These include:
- The procedure is less invasive—minimally invasive herniated disc surgery is much less traumatic to your body. Because it needs only a tiny incision, there will be minimal disruption of body organs, tissues, and muscles.
- It is an outpatient procedure—since this herniated disc surgical procedure is more minimally invasive than open surgery, it is outpatient, and you can be discharged from the hospital on the same day it is performed.
- High success rates—generally, the success rate of minimally invasive herniated disc surgery is high. One study found that eighty-four percent of patients who had minimally invasive herniated disc surgery reported excellent or good results, and the surgery resolved their mobility limitations and pain from herniated discs.
- Quick recovery—you will not take long to recover from minimally invasive herniated disc surgery. Anticipate moving easily after approximately 2-14 weeks and recuperating fully in about eight weeks. Plus, you will experience minimal pain, scarring, and bleeding than traditional open surgery.
Find a Qualified Neuro-Interventional Surgeon Near Me
Trust our team at Dr. George Rappard's Practice in Los Angeles to find a lifelong solution to your back or neck pain and other herniated disc symptoms so you can enjoy an active life again. Minimally invasive herniated disc surgery could be the answer you are looking for. Contact us at 424-777-7463 to schedule a comprehensive consultation and to learn more about our procedures and how we can help you.