Low back pain is spreading as an epidemic in the current era. One of the most important reasons for this is the change in lifestyle from active to sedentary and the shift in job profiles from outdoor jobs to desk jobs.
The problem that arises with bad posture and lifestyle is that age-related degeneration has shown a tremendous shift to the 3rd decade, where people aged 30-40 have started facing problems with their back.
Understanding Prolapsed Disc
One of the most common diseases of the back is a prolapsed disc disease where a part of the disc, which has degenerated, is thrown out of the normal disc space. This portion of the disc starts to compress the nerves in the spinal canal.
[Image of prolapsed disc compressing nerve]This compression causes pain in the buttock and down the whole leg, often accompanied by numbness. This group of symptoms is commonly known as Sciatica.
When is Surgery Needed?
The majority of patients who suffer from this disease have intractable pain that increases with prolonged sitting and standing. Fortunately, around 80% of patients will get good relief with conservative treatment (medication, rest, physiotherapy) after a period of 6 weeks to 3 months.
However, surgical intervention is considered for:
- Patients who do not get pain relief after 6 weeks of conservative care.
- Patients developing weakness in leg muscles (foot drop).
- Patients experiencing difficulty or straining while passing urine (Cauda Equina Syndrome).
What is Microdiscectomy?
Currently, Microdiscectomy is the gold standard procedure for this disease. It is a procedure wherein we remove the specific piece of disc tissue that has herniated and is compressing the nerve root.
This procedure utilizes a microscope or high-power magnifying loupes and a focused light source. This provides superior magnification and illumination, allowing the surgeon to see the nerves and vessels clearly.
The Procedure
This surgery is done under general anesthesia, preferably in a prone position. We expose one side of the spine and make a small hole in the backbone (laminotomy), preserving all the important joints and ligaments.
Through this small opening, we remove the disc fragment compressing the nerve. This immediately relieves the pressure on the nerve root, alleviating the leg pain.
Why choose Microdiscectomy?
This procedure is favored over traditional open discectomy because it offers:
- Less bone resection (preserving spine stability)
- Less bleeding
- Lower risk of post-operative back pain
- Reduced chances of adjacent segment degeneration
- Very safe due to high magnification
According to current literature, Microdiscectomy is still rated as a better procedure than Endoscopic discectomy, with lesser chances of recurrence.