Denton County Living Well Magazine July/August 2017 | Page 27

Minimally Invasive Microdiscectomy
By M. Viktor Silver, MD, FRCSC, FACS, FAANS
Overview and Indications
Microdiscectomy is performed for pa-
tients with a painful lumbar herniated
disc often known as sciatica. Microd-
iscectomy is a very common surgery
performed by spine surgeons. The op-
eration consists of removing a portion of
the intervertebral disc, the herniated or
protruding portion that is compressing
the spinal nerve root.
and stretch or walk for a little bit, then
sit down again if desired.
Brace
Patients are generally not required or recom-
mended to wear a back brace after surgery.
Shower/Bath
Patients can shower immediately after
surgery, but should cover the incision
area with a small bandage and tape,
and try to avoid water hitting directly
over the surgical area for 10 days. Pa-
tients should not take a bath until the
wound has completely healed, which is
usually around 2 weeks after surgery.
Today, many surgeons use a microscopic
surgical approach with a small, minimally-
invasive, one-inch incision to remove the
disc herniation, allowing for a more rapid
recovery with less blood loss, less pain
and shorter hospital stay.
Surgical Technique
A 1-inch longitudinal incision is made in the
midline of the low back, directly over the
area of the herniated disc. Special retrac-
tors and an operating microscope are used
to allow the surgeon to visualize the region
of the spine, with minimal or no cutting of
the adjacent muscles and soft-tissues.
A few millimeters of bone of the superior
lamina may be removed to fully visual-
ize the disc herniation. The nerve root
and neurologic structures are protect-
ed, so that the herniated disc can be
removed. Small dental-type instruments
and biting/grasping instruments are
used to remove the protruding disc ma-
terial. All surrounding areas are also
checked to ensure no additional disc
fragments are remaining. The total sur-
gery time is approximately 1 hour.
Driving
Patients may begin driving when the
pain level has decreased to a mild
level, which usually is between 2-10
days after surgery. Patients should not
drive while taking pain medicines (nar-
cotics). After patients feel comfortable
with a short drive, they can begin driv-
ing longer distances alone.
Return to Work and Sports
Patients may return to light work duties
Figure 1 (middle, above): Minimally Invasive as early as 1-2 weeks after surgery,
depending on when the surgical pain
Tubular Retractor allowing for minimal mus-
has subsided.
cle retraction with less pain, smaller incision
and faster recovery times.
Doctor’s Visits and Follow-Up
Patients will return for a follow-up visit
to see Dr. Silver approximately 8-10
days after surgery. The incision will be
inspected. Patients will be