Lumbar Spine Surgery: Herniated Disc
See Videos of Lumbar Microdiscectomy
See Select Photos of Microdiscectomy (click to enlarge)
Discs are soft, rubbery pads
found between the hard bones (vertebrae) that make up the spinal column. In the
middle of the spinal column is the spinal canal, a hollow space that contains
the spinal cord and other nerve roots. The discs between the vertebrae allow the
back to flex or bend. Discs also act as shock absorbers.
The
outer edge of the disc is a ring of gristle-like cartilage called the annulus.
The center of the disc is a gel-like substance called the nucleus. A disc
herniates or ruptures when part of the center nucleus pushes the outer edge of
the disc into the spinal canal, and puts pressure on the nerves. (See Picture)
As
people age, the disc begins to shrink and the spaces between the vertebrae get
narrower. Also, the disc itself becomes less flexible. Wear-and-tear, weight
gain, improper lifting or traumatic injury can all lead to this condition. The
fibrous outer ring may tear. As the disc material pinches and puts pressure on
the nerve roots, pain results. Sometimes fragments of the disc enter the spinal
canal where they can damage the nerves that control bowel and urinary functions.
Low
back pain, with sharp shooting pain that extends from the buttocks down the back
of one leg (sciatica), is most common symptom of a herniated disc. This is
caused by pressure on the spinal nerve.
Once
this condition is diagnosed and surgery is required the goal of the surgery is
to relieve the pressure on the nerve by removing that part of the disc that is
in contact with the nerve.
The surgery most often
required is call lumbar microdiscectomy.
Through a small incision in the mid back and the spinal cord and nerves
millimeters away, the disc portion that is pressing on the nerve is identified
and removed. In order to be as precise and accurate as possible an operating
microscope (See Picture) is used to help magnify the nerves and discs. The use
of the microscope allows for minimal tissue disruption during the surgery and
often a part of the remaining disc can be left in place. If the nerve is being
pinched as it goes through the opening in the bone on the way to or from the
spinal cord, then we will also perform a foraminotomy, which is a procedure
designed to expand the opening the nerve travels through. This surgery is
performed under general anesthesia with an overnight hospital stay.
The recovery is generally one to two weeks with most people able to resume normal activities after one month. The over all success rate for this type of operation ranges from 80 to 90%. As with any operation there are risks and these will be discussed with the patient prior to surgery. Please call 888-234-4357 to schedule an evaluation.
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© 2008 Tri-State Neurosurgical Associates - UPMC
Last Updated: January 1, 2008