Is a Minimally Invasive Microdiscectomy Right for Your Herniated Disc?

Herniated discs are far from uncommon and affect millions of Americans — the prevalence of lumbar herniated discs in the United States is about 12%. If you add cervical herniated discs to the total, the prevalence rate is even higher.

The good news is that, in most cases, herniated discs do heal with time and conservative treatments, such as rest and physical therapy. For a minority of cases, however, herniated discs don’t respond to conservative efforts, which often puts spine surgery on the table. 

In this blog post, Dr. Ali H. Mesiwala and his team discuss one of the more common surgical approaches for challenging herniated discs — a microdiscectomy. Here’s what we want you to know.

A brief discussion about disc herniation

Your spine consists of 33 vertebrae and 23 intervertebral discs, which separate the bony structures and provide shock absorption and spinal support.

These discs are made of a tough outer layer that contains fibrous cartilage. Called the annulus fibrosus, this exterior surrounds a soft, gel-like substance on the inside called the nucleus pulpous. 

When a disc herniates, it means that a piece of the disc has leaked out of its vertebral space and is compressing nearby nerve roots and fibers. As a result, people can experience a good deal of lower back pain, as well as symptoms that radiate down into the buttocks and legs, such as pain, numbness, and tingling.

Herniated discs primarily occur in the lower back and neck, as these two areas of your spine are most active. Drilling down further, about 95% of herniated discs occur in the lower back, mostly between the L4 and L5 or L5 and S1 vertebrae.

How a microdiscectomy can remedy a herniated disc

As we mentioned, in a majority of cases, surgery isn’t necessary for herniated discs. That said, some patients struggle with ongoing symptoms after four to eight weeks of conservative treatments, which makes surgery more of an option. In fact, between 400,000 and 500,000 discectomies are performed each year in the US, including microdiscectomies.

Whenever Dr. Mesiwala performs spine surgery, his goal is to perform only the necessary work with the least disruption possible, as is the case with a microdiscectomy.

As the name implies, a microdiscectomy is a procedure in which Dr. Mesiwala makes small incisions through which he threads specialized instruments and a camera. Once in position, Dr. Mesiwala trims the piece of disc material that's irritating nearby nerves. He may also shave away bone to relieve nerve impingement, which is called a laminectomy.

Benefits of a microdiscectomy

One of the main benefits of a microdiscectomy is that we’re only removing a small piece of your disc, not the whole thing. Removing an entire disc means we either need to fuse your vertebrae or replace the disc with an artificial one, both of which are much more involved procedures.

Another benefit is the success rate of a microdiscectomy — a 2002 analysis of more than 3,000 microdiscectomies found that 90% of patients had good-to-excellent outcomes. 

We should mention, however, that success rates are higher when we perform a microdiscectomy within 6-12 months of symptom onset. After a year, microdiscectomy success rates can dip to 80% or lower.

Lastly, your return to normal activities is much faster with a microdiscectomy than more complex spine surgeries. To start, we often perform microdiscectomies on an outpatient basis, which means you can go home on the same day. Once at home, we want you moving around, and you can slowly add activities over the following weeks until you’re back to your normal level.

As you can see, a microdiscectomy is certainly a great option for cases of stubborn herniated discs. To figure out whether this is a good solution for you, we invite you to contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to schedule a consultation today.