When your spine pain has reached a point where it’s a constant disruption to your life, you may be a candidate for a microdiscectomy with fusion surgery. These common procedures are typically performed in a way that’s as minimally invasive as possible. The procedure recommended will depend on the source of your pain and what part of the spine is affected. If a microdecompression and/or fusion is recommended, you are likely experiencing lower back pain or radiating nerve-based discomfort.
What is a Microdiscectomy and How is it Done?
If a microdiscectomy, also referred to as microdisc surgery, is recommended, it’s because you have disc material protruding from the inside of one of your spinal discs (disc herniation). This material may aggravate nearby nerve roots and cause pain felt in your hips, buttock, thighs, or legs. It’s often referred to sciatica if the sciatic nerve is involved.
Surgery to remove a problem disc was once performed exclusively as an open procedure called a discectomy. Due to developments with surgical techniques, the surgery can now be performed with less invasive methods. During the procedure, the damaged part of the disc is removed. In some cases, the entire disc will need to be removed.
When microdisc surgery is performed, small incisions are made so specially designed instruments can be inserted to reach the problem disc. Retractors are also used, in addition to a tube with a camera attached (fluoroscope) to allow the surgeon to view the affected area. A continuous or real-time X-ray is often used to provide additional guidance.
Part of a bone that covers the spinal canal called the lamina may be removed to further improve visualization. This may be the case if the herniated disc is in an area of the spine that’s difficult to reach. Relief following a microdisc procedure may be immediate if the primary source of pain was compression on a nerve root, although it sometimes takes several weeks for some affected nerves to fully heal.
When is a Fusion Performed with a Microdiscectomy?
A fusion may be done at the same time as a microdiscectomy if there is a need to restore spinal stability after disc material has been removed. Bone graft material is applied to the space where the disc was located. This material may come from a patient’s own bone (autograft) or involve the use of synthetic materials. Hardware that includes screws, rods, and clamps preserves stability of the spine until a fusion, or joining together of adjacent bones, occurs.
Small incisions and other minimally invasive techniques may be used to perform a fusion that will need to be performed at the same time that a microdiscectomy is performed. A live X-ray will guide the surgeon to the right location. The necessary hardware is put into place when the graft material is placed in the vacant space. It usually takes several months for a solid fusion to fully form.
Which Conditions May Require Fusion Surgery?
Fusion surgery is typically performed when the spine has become less stable. Instability may be created by age-related changes to discs (degenerative disc disease) or disc herniation. The spine may also become unstable if it has an abnormal shape (scoliosis) or if there are breaks within vertebrae (spinal fractures). Damage to spinal joints (facet joints) may also lead to instability of the spine, as can spinal growths, or tumors.
Who Are Ideal Candidates for Microdisc and Fusion Surgery?
Ideal candidates for minimally invasive microdisc and fusion procedures are patients who are otherwise healthy. Many surgeons also prefer individuals who do not have underlying health issues like diabetes or high blood pressure that aren’t under control. Minimally invasive procedures often mean fewer surgery risks, shorter hospital stays, and faster recovery and recuperation times.
The results you will likely see with microdisc and fusion surgery will depend on how well you respond to follow-up care, which usually includes physical therapy or rehabilitation. Gauge your return to normal activities following surgery based on how well your spine is healing. Paying attention to posture, adopting an appropriate exercise routine, and being mindful of what you eat can also help speed up the healing and recovery process.