Lumbar microdiscectomy (PP code V2452)
Patients with a slipped disc in the lower back do not usually require surgery. The majority (>80%) will resolve within 6-8 weeks of the onset of symptoms. The indications for surgery include:
- pain persisting for more than 8 weeks
- severe unremitting pain of any duration that is uncontrollable with opiate analgesia
- a progressive neurological deficit (evolving foot drop or sensory loss)
- cauda equina syndrome (indication for an emergency operation)
The operation is carried out as microsurgery through a small incision using an operating microscope. It involves general anaesthesia and takes approximately 45 minutes. Some patients can be treated as day cases but most patients go home the day after surgery. The wound is closed using a cosmetically sensitive technique with dissolving stitches so there are no clips to be removed.
The risks of surgery include:
- spinal fluid leak
- DVT/PE (clots in legs / lungs)
- scar tissue
- recurrent symptoms
- accelerated degeneration
- nerve root injury
- pain, numbness
- weakness, paralysis
- incontinence, impotence
- general anaesthetic complications (heart attack, stroke)
Following surgery the patient may notice some lower back pain and stiffness but this should settle with simple anti-inflammatory medication such as ibuprofen. Some patients will develop tingling in the legs after surgery due to swelling around the nerves at the site of the operation. This is temporary and will usually settle down after a few days.
Patients do not usually need to wear a back brace or support. Specialist spinal physiotherapists will advice each patient on a postoperative exercise regime, to encourage back movements. Further outpatient physiotherapy sessions will be offered, where indicated.