(This is the section that explains the detail of the operation or procedure above and should be read in conjunction with the section called your back operation).

A lumbar microdiscectomy is performed for a slipped disc. The aim of the operation is to remove the bit of the nucleus pulposus (see the section called your back operation) that has herniated through the annulus fibrosus. The important thing to realise is that the remainder of the nucleus pulposus will remain behind and can herniate through as well and cause repeat symptoms. This is one of the complications following microdiscectomy.

The reason that your surgeon performs this procedure and not a larger operation is because he or she is trying to be as conservative as possible in doing your surgery. It is hoped in the future that these damaged discs might be repaired perhaps removing the need for an operation at all.
Some progress in the less invasive surgery front has been made by laser surgery, endoscopic surgery and percutaneous nucleoplasties. Enquire from your surgeon whether these would not be an option for you and also consult a surgeon that is proficient in these techniques as well as the usual open surgery techniques.

When undergoing this operation, you will be lying on your stomach on bolsters or pillows during your procedure. Your surgeon will make a small cut along your spinous processes. This cut can vary from two or three centimetres to a slightly larger cut.
The length of the cut is actually immaterial to the success of the operation and a surgeon should never complicate the operation by trying to make the cut too short. The soft tissue and muscles that are attached to the vertebraes are then stripped off by a combination of electrosurgical cautery (ablade that cuts with an electrical current) and dissecting instruments. A small amount of bone as big as the nail on your little finger or less is removed along with some ligaments. This allows direct access to the nerves. They are retracted and the disc fragment is removed. Thereafter the wound is stitched up.

Ward care

You would be expected to get out of bed quite early and usually on the first day following surgery or even on the same day. You may usually walk around as much as you want but should be careful of sitting for too long or on a seat that is very low. This is to prevent you from having a repeat disc prolapse (herniation). Most surgeons recommend a duration of 30 minutes or less of sitting at a time. It is best to sit on a chair that is at the height of a barstool.

Discharge

You would normally be discharged two days or so after your operation but some centres are even doing these cases as day-cases. Staff at the hospital will take care of your follow-up consultation, analgesia to take home, sick certificate and wound care provisions in the post-operative period.

Rehabilitation

It is incredibly important to get a lot of rest and exercise following your surgery. Do not try to rush back to work. It is important to walk for exercise and also exercise in conjunction with the guidelines from your physiotherapist. You may perform activities only as prescribed by your health care provider. You should refrain from exercises that involve impact for at least three months. This would include jogging, mountain biking and equestrian pursuits.

Follow up

You will usually be seen after six weeks but will be seen earlier if there are any complications. It is important to realise that you will have to protect your back the rest of your life with good back habits. See the section on exercises to see what you can do to keep your back healthy.