This operation is used to remove a disc prolapse that is causing compression of a nerve root(s) in the lumbar spine. The typical symptoms include any combination of pain, numbness and/or weakness that goes down the leg.
In rare occasions the pressure can affect all of the nerve roots supplying the bladder, bowel and genital region, this is called cauda equina syndrome. Patients with cauda equina syndrome present with issues such as incontinence of urine/faeces, numbness of the perineum, as well bilateral leg pain/weakness/numbness. This is a surgical emergency and patients with these symptoms should present immediately to the emergency department.
The operation is performed under general anaesthesia with the patient positioned face down on a specialised operating table. Xray is used to carefully check the correct level, and then a small incision is made in the skin over this area.
Using specialised retractors and a surgical microscope, the muscle on the affected side of the spine is elevated, and the bone is visualised. A surgical drill is used to thin the bone covering the spinal canal (the lamina) and then surgical instruments are used to visualise the nerve root being compressed. The nerve root is protected and then the disc fragment is removed. The nerve is then checked to make sure there is no further compression.
You will be taken to the recovery room for monitoring and when safe you will be sent to the surgical ward. Depending on the length of time your symptoms have been present, the leg pain may have already improved when you wake up. Cauda equina is less predictable, and full recovery of nerve function is not always possible.
You will be given food and drink when you feel ready. The following day you will be assisted to walk, and when safe you will be allowed to go home. Most patients stay in hospital one or two nights.
After being discharged, you will be given regular analgesia to ensure you are comfortable. You will be encouraged to walk and perform exercises as prescribed by a physiotherapist. Avoid bending, twisting, and carrying heavy objects until advised by Dr Anderson, as this is a risk for recurrence of the disc prolapse.
Most people will have a reduction in the amount of leg pain, however in some instances this does not completely resolve or may take some time to improve. The risk of this is higher if you have had the symptoms for a long period of time.
The risks of surgery include, but are not limited to:
Dr Anderson will discuss these with you during your consultation, as well as any other specific questions that you may have about the procedure