Patients mostly suffer from nerve pain the leg, also called sciatica. In older age patients it may occur due to degenerative changes which leads to stenosis or narrowing of spinal canal. Also known as spinal stenosis, this condition usually causes signs of pain and numbness in the legs while walking or standing.
Please note that surgery is advisable only when there in no significant improvement after long term medical management, injections or physical therapy. If your pain subsides or improves with these treatments and does not affect the quality of your daily life activities, surgery would not be required. It is advisable not to ignore the initial symptoms. In terms of recovery and outcome, it is suggested that the best time to go for surgery is only after four months of trying non surgical treatments. You can also take measures like weight reduction (in case of overweight patients), stop smoking and go for fitness therapies like aerobics.
Microdiscectomy gives comparably better results than open discectomy. It involves shorter hospital stay and early return to daily life activities. Until few years ago, discectomy inlvoved longer hospital stay as the surgery was performed through longer incisions. But today, surgeons use microscopic surgical approach that involves small minimally invasive incision to remove the portion of diseased disc leading to faster recovery.
The surgery is performed under general anesthesia. IV antibiotics are given before surgery and patient is positioned on the operation table by lying on the stomach. He/she is put on ventilator to support breathing during the surgery. The surgeon then makes a small incision on the back over the affected area. Microscope and special retractors are used to visualize the diseased disc. Care is taken that minimal or no cutting occurs for the adjacent soft tissues and muscles. In order to make sure that the correct disc is identified , an x-ray is also taken. Now the diseased disc is cautiously removed and the surrounding areas are checked to make sure that there are no extra disc fragments remaining.
Next, the incision site is closed using staples or stitches. The staples are usually removed after a week or two depending upon wound healing, while the stitches dissolve completely.
After the successful completion of operation, patient is kept under observation for few hours and then gets shifted to the ward. Total hospital stay varies from 1 to 3 days. During the post op stay in hospital, physiotherapists and occupational therapists visit regularly and instruct on the correct techniques of walking and getting in or out of bed. This is done strengthen the back and teach proper body movements after surgery. Patient is motivated to get out of bed as soon the numbness goes away.
A corset or brace is needed to give extra support to the patient's back after surgery. Measurement for brace is taken and made on order. This has to be put while sitting on chair or walking. If patient has to sit for a short while or has to go to the bathroom, it need not be worn.
Patient may get back to routine life or work in 2 to 4 weeks time. But any strenuous activity can be done only after 4 to 8 weeks of surgery.
Following points need to be taken care of during recovery period:
Follow up visit is required approximately 8 to 10 days after surgery. The doctor will examine the incision area/surgical site and remove stitches. He will give prescription and explain the instructions to be followed in the long run.
The outcome of this surgery has shown excellent results and most of the patients have noted significant improvement in pain soon after surgery and have returned to normal pain-free life!
Following are some of the risks that can be linked with this surgery:
All the above points can be avoided or taken care of if the patient is in the right hands, that is, under the care of expert doctor and healthcare facility.
Please note that treating doctor should be contacted immediately under the following situations: