Surgery through a Tiny Incision — Microdiscectomy

Dr. Tinley sees patients every day who come in describing pain they are having in a leg and the foot on that same side. They also often have a certain degree of numbness and sometimes weakness. These are classic symptoms of nerve compression, probably on one of the nerve roots exiting the spinal canal to the impacted area. But these same patients aren’t interested in open back surgery, with the long incision, cut muscles, and other issues. It makes them resist surgery and opt to live with the pain for longer than is necessary.

Open surgery often isn’t necessary, as Dr. Tinley can often solve the patient’s pain with minimally invasive surgical methods. One procedure is called a microdiscectomy. At DFW Center for Spinal Disorders, Dr. Tinley performs these minimally invasive surgeries.

If you follow golf, its most famous professional, Tiger Woods, just shared with the world that he had a microdiscectomy at the end of 2020. The surgery was necessary to “remove a pressurized disc fragment that was pinching a nerve.” This is the fourth microdiscectomy for Woods, who had the three previous surgeries in 2014 and 2015 before finally going ahead with fusion surgery in 2017.

What is a microdiscectomy?

This procedure is performed through a small incision in the midline of the lower back. And we mean small — the incision length is typically only 1 to 1.5 inches long! The goal is to go in and remove the portion of the disc that has herniated and is pushing on the nerve root. In most cases, some of the facet joint, is removed to further ensure the nerve compression is relieved.

How is a microdiscectomy performed?

To access the disc causing the trouble, Dr. Tinley makes the small incision in the midline of the low back, directly above the herniated disc. The back muscles need to be moved. Since they run vertically, they can be pushed to the side rather than needing to be cut. This makes for easier recovery. The muscles are lifted off of the bony arch, called the lamina, on the back of the spine. In most cases, an operating microscope is inserted in a tube through the tiny incision to allow our surgeons to clearly visualize the nerve root.

To facilitate access to the disc and the nerve root, in most cases a portion of the inside facet joint is removed. This also helps ensure compression on the nerve root is minimized or totally alleviated.

Now, the nerve root is gently moved to the side and we cut away the portion of the disc that has pushed outward onto the nerve root. Only the herniated portion of the disc is removed, leaving the healthy remainder intact.

Afterwards

In most cases, the patient has immediate pain relief now that the disc is no longer irritating the nerve root. In some cases, it may take weeks or months for the nerve root to fully heal. During this time, there can be enduring numbness or weakness, but as the nerve root heals, this decreases and normal function and feeling returns.

Do you have chronic pain in one of your legs and the corresponding foot? You could have a herniated disc and could benefit from a microdiscectomy. Call Dr. Tinley at (817) 916-4685 and set up a consultation.

Posted in: Minimally Invasive Spine Surgery (MIS)

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