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Lumbar Disc Surgery
Between the bones of the spine (vertebrae) there is soft tissue which acts like a shock absorber. This disc material is held in place by strong ligaments or sinews that also hold the bones together by encircling them. If the ligaments are damaged by injury or wear-and-tear, they may give way and the disc may bulge.
This
bulge (prolapse) of the disc may cause pressure on the nerves that pass from the
spine to go to the leg. This causes pain that is typically felt in the leg with
accompanying backache. The pressure on the nerve may lead to numbness in the
leg with or without weakness in the muscles.
Conservative treatments should be tried first. Conservative treatments include bed rest with pain medications for a few days, physical therapy, chiropractic treatments, nerve blocks, epidural blocks, exercises, etc. When such conservative treatments fail to improve symptoms, surgical treatments have to be considered. One such procedure is "microdiscectomy."
Microdiscectomy is an "open surgery" carried out through an incision made in the lower back while the patient is under a general anesthetic. The bulge is removed to relieve pressure on the nerve thereby relieving the pain. Generally there is a 80-95% chance of relieving pain with this type of surgery. For some patients, open surgery is not needed. Procedures like LASE may be appropriate and involve lower risk and faster recovery.
After disc removal, most patients still have some residual back pain. This may be no more than a stiffness in the lower back first thing in the morning or it can occasionally be more troublesome and require treatment.
Most surgeons agree that even a successful surgery may not correct all numbness or weakness. Unfortunately, sometimes these symptoms may be due to damage to the nerve by the disc and not just pressure on the nerve. Under these circumstances, numbness or weakness may not be reversed even though the pressure has reduced. When a nerve recovers after surgery it does so slowly.