Is Surgery The Next Step For Chronic Back Pain?
There comes a time when a patient must decide on the next steps for chronic back pain or severe leg pain. These patients suffer from spinal conditions like degenerative disc disease, herniated discs, or spinal stenosis. When months of pain management and physical therapy bring no relief, surgery may help relieve the symptoms of the condition and restore mobility. The surgeon will present the option of minimally invasive microdiscectomy or laminectomy. Both procedures will bring relief, but microdiscectomy has some added benefits.
Discs versus bones
Chronic back or leg pain is often due to an issue with the disc or lamina. Between each vertebra are discs that support the spine and help with movement. These discs consist of collagen, proteins, and water. Discs can lose hydration and degenerate or shift out of place, pressing nearby nerves. On the other hand, the lamina is the flat part of the vertebrae that covers the spinal cord. The lamina spreads on each side of the spinous process, forming a slight arch. Due to arthritis or bone spurs, the lamina can become larger or change shape, pressing on the nearby nerves.
What is minimally invasive microdiscectomy?
Minimally invasive microdiscectomy removes the part of a damaged disc to bring relief to nearby nerves. The surgeon can access the spine using incisions the size of buttonholes. The patient is first placed under general anesthesia. The surgeon will make the first incision and insert a scope with a camera and light attached. Going through another incision, the surgeon uses tools to access the herniated disc. Part of the nearby facet joint and part of the disc may be removed.
A laminectomy can also relieve pressure on nearby nerves by removing part or all of the laminae. The surgery requires a 2-5-inch incision at the middle of the back. The surgeon can move nearby muscles and tissues to accommodate the surgery. Next, one or both sides of the bone are removed, along with parts of the facet joint. Once no more bone is affecting the nerves, the surgeon closes the incisions.
Smaller incisions, faster surgery
Minimally invasive microdiscectomy has smaller incisions compared to laminectomy. These smaller incisions mean that most patients can leave on the same day as the surgery. Microdiscectomy is considered an outpatient procedure, performed at surgical centers. A laminectomy may require additional time in the hospital, which is not appealing to all patients. With minimally invasive surgery, the patient can choose the best date for surgery, bringing the added benefit of convenience.
Smaller incisions, faster recovery
Recovery time is a common concern patients have with any surgical procedure. Large incisions can take several weeks to heal, leaving patients out of work and social activities. On the other hand, minimally invasive surgery means smaller incisions, which means a shorter healing window. On average, laminectomy patients need 3-6 months to fully recover. However, microdiscectomy patients can resume normal activities in as little as 8 weeks.
Less risk, more success
With minimally invasive surgery, there is a reduced risk of infection. However, a laminectomy may have larger incisions, which can be harder to manage. The additional time in the hospital also increases the chances of infection. Discectomy has excellent outcomes, with up to 89% success rates. Both procedures can relieve pain, stiffness, and symptoms like sciatica. However, microdiscectomy may make the process smoother.
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