- Copyright 2023 NeuroCure - Konstantia Stoforou MD PhD - Neurosurgeon
MICRODISCECTOMY MIS
Microdiscectomy MIS - What it is and which are its indications?
Microdiscectomy MIS is the surgery indicated in patients with intervertebral disc herniation with concomitant intractable pain or/and neurological deficits (paralysis, hypoaesthesia, etc.). Microdiscectomy MIS is the most frequent surgical operation of Neurosurgeons and is the type of intervention applied to the permanent restoration of a lumbar intervertebral disc herniation.
Microdiscectomy MIS is an intervention that is now a routine procedure in adults. It is the definitive therapeutic option when the methods of conservative treatment (medication, physiotherapy) do not work after 6-8 weeks, or other minimally invasive surgery (Transdermal discogel spine discoplasty MIS, Endoscopic microdiscectomy MIS) have failed or when neurological deficit coexists and symptoms are getting worse.
Microdiscectomy MIS - What is the purpose of the intervention?
With this intervention, the decompression of the nerve is ensured and thus the patient is relieved of pain but also the reduction of symptoms such as numbness or weakness of the limbs.
Previously, before the surgical microscope appeared, the incision performed for the Microdiscectomy MIS was quite large and the patient’s hospital stay and post-operative recovery process were greater. Today many neurosurgeons use microscopic access with very small incisions, and minimally invasive methods, thus ensuring a much shorter recovery period.
Microdiscectomy MIS - How is it performed?
Microdiscectomy MIS is performed with general anesthesia. Prophylactic antibiotics are always recommended and the patient is placed in a prone position on a special surgical table with special coatings. The area where the disc to be operated on is located with a C-arm radiograph to accurately position the surgical incision. The incision has a length of 1-2 cm and special dilators are positioned just above the point where the problem is, so that the muscle wound is minimal.
The correct position is confirmed by radioscopy, and then the neurosurgeon, with the help of the surgical microscope, proceeds to remove only the part of the disc causing the problem without damaging the remaining disc that must remain in the intervertebral space.
After removing the part of the disc, the area is checked for residual pieces or bleeding and rinsed well. The expanders are then removed and the wound is sutured.
The time of Microdiscectomy MIS surgery lasts usually for about an hour.
Microdiscectomy MIS - Frequent questions
Most patients can go home the same day or early next day after the Microdiscectomy MIS procedure.
Before the patient leaves the hospital, physiotherapists provide instructions for mobilization, abandonment of the bed and walking.
It is also recommended to avoid weight lifting, bending and turning movements for 2-4 weeks to avoid hernia recurrence.
It is also very beneficial to gradually start walking, while sitting should be avoided for more than 45-60 minutes.
It is usually not necessary. Occasionally, depending on the circumstances and the patient, it may be necessary for a little better lumbar support in the immediate postoperative phase.
No special care is needed in most patients, it is enough to see that the area remains clean with the help of a small gauze to avoid contact and irritation from clothing.
The patient can have a bath immediately after a Microdiscectomy MIS surgery, provided the incision is covered with a waterproof gauze so that it does not get wet. After bathing, the gauze should be removed, the area dried well and a small sterile gauze should be placed. Routine bathing can be done after 2 weeks of surgery and if the wound is healed completely.
The patient can safely drive following termination of postoperative pain, usually from 3 to 10 days after the operation. The patient is forbidden to drive under the influence of opioid analgesics.
However, it is not advisable to make long trips for up to 2 months after the operation.
Παρ’ όλα αυτά δεν συνίσταται να γίνονται πολύωρα ταξίδια για ένα διάστημα έως 2 μηνών μετά.
The patient can return to not very demanding duties in 1-2 weeks.
To sports and regular work he can return in 6-8 weeks provided that postoperative pain has fully receded and muscle strength has returned.
Σε σπορ και κανονική δουλειά μπορεί να επιστρέψει σε 6-8 εβδομάδες εφόσον ο μετεγχειρητικός πόνος έχει πλήρως υποχωρήσει και η μυϊκή ισχύς έχει επανέλθει.
The patient will need re-examination in 10 days’ time after a Microdiscectomy MIS surgery, for the surgeon to inspect the surgical incision and examine the patient.
The outcome in Microdiscectomy MIS surgeries is usually excellent with complete pain relief immediately postoperatively. Success is over 95%.
Most patients improve immediately after a Microdiscectomy MIS procedure and return to work and to everyday life activities without any problems.