Lumbar Microdisectomy
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The Surgical Procedure

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Your surgeon will:

1. review your neurological history and examination;
2. review your diagnostic studies (such as a myelogram, CAT scan or MRI);
3. plan a surgical approach; and
4. review the procedure with you.

In the operating room, a lumbar microdiscectomy begins with a small incision in your lower back. Through this opening, your surgeon will insert microsurgical instruments. Because the work is viewed through a microscope (Fig. 6, above), this approach requires a relatively small incision.

Guided by diagnostic studies, your surgeon will remove a small portion of bony material from the back of your vertebra (Fig. 7). Once this material is removed, the surgeon can locate the exact area where the nerve root is being pinched.

Once the "pinched" nerve is located, the extent of the pressure on the nerve can be determined. Using microsurgical procedures, your surgeon will remove the ruptured portion of the disc and any disc fragments which have broken off from the main disc (Fig. 8). The amount of work required to complete your microdiscectomy will depend in part on the number of disc fragments present and the difficulty presented in finding and removing them.

Once the ruptured disc has been removed, healing can begin (Fig. 9). Healing is the body's natural process of restoring its damaged tissues to a normal, or nearly normal condition. Healing occurs on its own, but is influenced by such factors as general good health, physical fitness, nutrition and rest. Recovery is the process during which you work at becoming well. You must commit yourself to staying in good health (exercising), maintaining a positive mental attitude and following your physician's instructions.

What to Expect After Surgery

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During the recovery period in the hospital and at home, try to rebuild your strength gradually. Rest when you feel fatigued - but be persistent in your efforts.

It is important for you to recognize that we all heal at a different rate. The speed at which you will recover depends in part on your age, your general level of health, your overall physical fitness and your mental attitude. Generally, you will heal more slowly if you are overweight, out of shape or smoke, or if you are a diabetic or have other pre-existing medical problems.

It is normal to have some pain after any operation. After a lumbar microdiscectomy, there may be some leg "aching" which occurs as the nerve(s) attempts to heal. You also may feel some muscle spasms across your back and down your leg(s). And if there was inflammation in the nerve root, some pain may persist until this inflammation diminishes. You will be given appropriate medication to control your pain, relieve back spasms and reduce inflammation.

Commit to a Healthy Lifestyle

Now is the time to commit yourself to a healthier lifestyle. You can begin by taking these important steps:

* Watch your weight: If you are overweight, you must gradually return to your proper weight. Crash diets rarely work. Commit yourself to better eating habits and stay with them for the rest of your life.

* Become more active: Your physician will tell you when you can resume normal physical activities after surgery. Make up your mind now that you will develop a regular aerobic exercise routine, such as walking, swimming or riding a bike. However, always check with your physician before starting any exercise program.

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