Microdiskectomy is done in a hospital or outpatient
surgical center while you are under local anesthesia (awake but pain-free)
or general anesthesia (asleep & pain-free).
A special high-powered microscope magnifies the affected disk(s) and
nerves, and guides the doctor during surgery. The surgeon makes a small cut
on your back and moves the back muscles away from the spine. After
identifying and moving the nerve root, the surgeon removes the injured disk
tissue and fragments. The back muscles are placed back into the normal
position, and the wound is closed with stitches or staples.
Spinal microdiskectomy is done to relieve nerve pain and pressure. It may
be performed in patients with the following conditions:
- Cauda equina syndrome
- Herniated lumbar disk
Sciatica
Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is
caused by injury to or compression of the sciatic nerve. Sciatica is a
symptom of another medical problem, not a medical condition on its own.
Causes
Sciatica occurs when there is damage to the sciatic nerve, located in the
back of the leg. This nerve controls the muscles of the back of the knee and
lower leg and provides sensation to the back of the thigh, part of the lower
leg and the sole of the foot. Incomplete damage to the sciatic nerve may
appear identical to damage to one of the branches of the sciatic nerve
(tibial nerve dysfunction or common peroneal nerve dysfunction).
Common causes of sciatica include:
- Degenerative disc disease
- Pelvic injury or fracture
- Piriformis syndrome (a pain disorder involving the narrow piriformis
muscle in the buttocks)
- Slipped disk
- Spinal stenosis
- Tumors
Sciatica pain can vary widely. It may feel like a mild tingling, dull ache,
or a burning sensation. In some cases, the pain is severe enough to make a
person unable to move.
The pain most often occurs on one side. Some people have sharp pain in one
part of the leg or hip and numbness in other parts. The sensations may also
be felt on the back of the calf or on the sole of the foot. The affected leg
may feel weak.
The pain often starts slowly. Sciatica pain may get worse:
- After standing or sitting
- At night
- When sneezing, coughing, or laughing
- When bending backwards or walking more than a few yards, especially
if caused by spinal stenosis
Spinal Fusion
Spinal fusion is surgery to correct problems in the spine bones
(vertebrae). The surgery stabilizes the back by permanently placing certain
bones in the spine together. Fusing means two bones are permanently placed
together so that movement between them can no longer occur. Spinal fusion is
usually done along with other surgical procedures of the spine, such as a
diskectomy.
Description
Spinal fusion surgery uses bone grafts, with or without screws, plates,
cages, or other devices. The bone grafts are placed around the problem area
of the spine during surgery. As the body heals itself, the graft helps join
the bones together. The most common spinal area treated is the lower
(lumbar) spine. However, it can also be done on the upper (cervical) spine.
The procedure is performed while you are under general anesthesia
(unconscious and pain-free). The surgeon makes a cut over the area of the
spine that will be treated. If you are having a problem in the lower spine
corrected, the repair is done through a surgical cut made directly over the
spine. This is called the posterior lumbar approach.
If you are having a problem in the upper spine corrected, the repair is
usually done through a surgical cut in the front or side of the neck
(Anterior Cervical spine). If you are having a problem in the middle spine
corrected, the repair is sometimes done through a surgical cut in the chest
and abdomen (anterior thoracic spine). Depending on the reason for surgery,
the procedure may involve a combination of surgical cuts.
Spinal Stenosis
Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck)
spinal canal, which causes compression of the nerve roots. Cervical Spinal
stenosis mainly affects middle-aged or elderly people. Cervical spinal
stenosis may be caused by osteoarthritis or Paget's disease or by an injury
that causes pressure on the nerve roots or the spinal cord itself.
Symptoms
- Back pain that spreads to the legs
- Difficulty or imbalance when walking
- Leg pain
- Neck pain
- Numbness in the buttocks, thighs or calves, that is worse with
standing, walking, or exercise
- Pain in the buttocks, thighs, or calves that is worse with walking or
exercise
- Weakness of the legs
Generally, conservative management is encouraged. This involves the use of
anti-inflammatory medications, other pain relievers, and possibly steroid
injections. If the pain is persistent and does not respond to these
measures, surgery is considered to relieve the pressure on the nerves.
Cervical spinal stenosis surgery is performed on the neck or lower back,
depending on the site of the nerve compression.
