this patient presented with severe radiculopathy causing difficulty in walking. Surgery was done using casper retractors. Patient was discharged on day 1 of surgery and had complete recovery.
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Lumbar Microdiscectomy
Overview:
Microdiscectomy is a surgical procedure to remove the damaged portion of a herniated disk in your spine. A herniated disk can irritate or compress nearby nerves. Diskectomy is most effective for treating pain that radiates down your arms or legs.
Your doctor may suggest discectomy if medical, nonsurgical treatments (eg Physiotherapy) haven't worked or if your symptoms worsen. There are several ways to perform a discectomy. We prefer minimally invasive discectomy, which uses small incisions and a Microscope (Carl Ziess Tivato) for viewing the procedure.
What is Disc herniation?
Its commonaly known as Sciatica in community. This condition occurs when some of the softer material inside the disk pushes out through a crack in the tougher exterior. It causes pressure on spinal nerve.
What are indication of surgery in Herniated disc?
• You have trouble standing or walking because of nerve weakness (Sensory/motor deficits)
• Conservative treatment, such as mediciens, physical therapy or analgesic injections, fails to improve your symptoms after 4-6 weeks
• Pain radiating into your buttocks, legs, arms or chest becomes too much to manage
• Loss of bowel / bladder control
Why Microdiscectomy is done?
Microdiscectomy is performed to relieve the pressure a herniated disk (also called a slipped, ruptured or bulging disk or disk prolapse) places on a spinal nerve.
Risks
Microdiscectomy is considered a safe procedure. But as with any surgery, microdiscectomy carries a risk of complications. Potential complications include:
• Infection
• Leaking spinal fluid
• Injury to blood vessels or nerves in and around the spine
How you prepare
You'll likely need to avoid eating and drinking for a certain amount of time before surgery. If you take blood-thinning medications, you may need to adjust your dosing schedule before surgery. Your doctor will give you specific instructions.
What you can expect
During diskectomy
Surgeons usually perform Microdiscectomy using general anesthesia, so you're unconscious during the procedure. Small amounts of spinal bone and ligament may be removed to gain access to the herniated disc.
Ideally, just the fragment of disc that is pinching the nerve is removed, relieving the pressure but leaving most of the disc intact.
After discectomy
After surgery, you're moved to a recovery room where the health care team watches for effects of the surgery and anesthesia. You may be healthy enough to go home the next day you have surgery, although a short hospital stay may be necessary — particularly if you have any serious pre-existing medical conditions.
Depending on the amount of lifting, walking and sitting your job involves, you may be able to return to work in two to three weeks. If you have a job that includes heavy lifting or operating heavy machinery, your doctor may advise you to wait four to six weeks before returning to work.
Results
Discectomy reduces herniated disk symptoms in most people who have clear signs of nerve compression, such as radiating pain. However, diskectomy may not be a permanent cure, because it doesn't do anything to reverse the process that allowed the disk to become herniated in the first place.
To avoid re-injuring your spine, your doctor may recommend weight loss, prescribe a low-impact exercise program, and ask that you limit some activities that involve extensive or repetitive bending, twisting or lifting.
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