Microsurgical Discectomy for persistent leg pain.
This procedure is usually undertaken for patients with a disc prolapse. A microscope or magnification loupes with high intensity headlight are used. Severe leg pain is the usual symptom. The operation is done through a 2-5 cm incision over the back. An x-ray is taken to confirm the correct level has been identified. It may be necessary to remove a small amount of bone to provide access to the neural canal. The dura is then exposed and moved slightly to expose the disc and the prolapsed material. This is removed leaving the majority of the disc behind. An epidural injection of local anaesthetic is often given to reduce postoperative pain and the wound is repaired. Following the operation, the patient is allowed out of bed as soon as possible and is usually ready for discharge one to two days post operation.
Success rates: The majority of patients will get a big reduction in the leg pain. This is usually immediate, although some patients can have discomfort for several weeks after the operation. Recovery of weakness and numbness are much less predictable.
Risks of Surgery: Apart from the general risks of any operation, an operation on the spine has other risks. These include further nerve damage and infection. Both of these complications are very rare. The main worry is of paralysis. Fortunately, this risk is exceptionally rare after Microdiscectomy. Recurrent prolapse can occur in about 7% of cases and may require further surgery. A post-Discectomy syndrome can occur and, if severe, may require further surgical treatment.