According to the Centers for Disease Control, back pain is the leading cause of disability and missed work in the United States. “The biggest cause of back pain is damage to disks,” said Neurosurgeon Michael Doyle, MD. “Disks are the spine’s shock absorbers, the cushions between the bones, or vertebrae, that make up the spine. Pain can be caused when disks become compressed due to age, injury or disease. Occasionally, a disk will become herniated, which means that the fibrous outer covering has broken or become distended to the point where the disk presses on a spinal nerve. Both these conditions respond well to non-operative treatments such as exercise, lifestyle adjustments, physical therapy and pain management with anti-inflammatory medication. Sometimes, however, a herniated disk will require surgery to ease the excruciating pain it can cause and to prevent permanent damage.”
A diskectomy is the surgical removal of the disk or portion of the disk that is pressing on the nerve. “In the past,” explained Dr. Doyle, “the surgery required a large incision, significant recovery time and considerable postoperative pain. Now, however, a minimally invasive procedure called a microscopic diskectomy can often be used instead.”
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As Dr. Doyle explained, “The procedure requires only a small incision and removes only the portion of the ruptured disk that is pressing on spinal nerve roots. During the operation, we make an incision through which we pass a series of dilating tubes to spread apart the muscle tissues rather than cutting through them. We use a fluoroscope to ensure that the route to the herniated disk is made in the correct location. We can then insert the surgical light and tiny camera or microscope, and clear away the herniated portion of the disk. The surgery itself is basically the same as with the open procedure except that a tiny incision gives us the access we need because we use micro-instrumentation.
When the herniated portion of the disk is extracted, the instruments are removed, which allows the body tissue to close around the area. A small bandage is used to close the surface incision. The surgery is usually performed on an outpatient basis, which allows the patient to leave the hospital the same day. “Patients bounce back quickly from this procedure, and often experience pain relief that is almost immediate,” said Dr. Doyle.
When is microdiskectomy considered?
Lumbar microdiskectomy is an option for patients when certain specific conditions are met. In general, surgery is recommended when a ruptured disk is pinching a spinal nerve root and causing the following symptoms:
• Leg pain that limits your normal daily activities
• Weakness in your leg(s) or feet
• Numbness in your extremities
• Impaired bowel and/or bladder function
• Symptoms fail to improve with non-operative treatment
“A herniated disk can cause pain that is almost unbearable. The microscopic diskectomy is an advanced, minimally invasive surgical procedure that can be extremely effective in relieving pain for patients who meet certain medical criteria. Because the procedure requires only a tiny incision, causes less post-operative pain and less muscle injury, patients bounce back more quickly.”
Michael Doyle, MD
Board Certified Neurosurgeon