Lumbar Discectomy

Operation
also known as microdiscectomy, lumbar fenestration and sequestrectomy.

Indication
Sciatica, lateral recess stenosis, lateral disc prolapse and spinal stenosis

Pre-assessment
yes

Special preparation for surgery
stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.

Admission to hospital
on day of operation

General anesthetic
yes

Operation position
Prone (lying on front)

Details of operation
An incision of 3-4 cm is made in the back to enable dissection to the spine by elevating the muscle and ligaments from the bone on the side of the pain. A window (fenestration) is made by removing small amounts of bone and ligament to expose the nerve sac (Dura). The Dura is moved to the side to allow a view of the disc fragment. The fragments are removed to allow the nerve to be freed.

Length of surgery
1 hour

Urinary catheter required
No

Post-operative drain required
no

Post-operative antibiotics
Yes (occasionally long acting antibiotics will be given during the operation so that none may be required after surgery)

Post-operative iv fluids ( drip)
intravenous fluids

DVT prophylaxis
Aspirin post- operatively

Mobilization after surgery
Within 12 hours

Length of stay in hospital
1 – 3 days

Post hospital recovery
2 weeks resting while wound heals followed by
2- 4 weeks increasing daily activities. At week 4-6 post operatively normal activities should be able to be resumed.

Sutures removed
Dissolvable

Dressing
Dissolvable glue dressing

Review appointment
6 weeks

Physiotherapy
Not usually

Return to driving
2 weeks

Return to work
3-6 weeks depending on nature of work