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Lumbar spine microsurgery is a type of minimally-invasive spinal surgery to relieve pressure on compressed nerves in your lumbar spine (lower back). Most spinal operations are done using open surgery techniques, however in some cases it is possible to use a minimally invasive technique (sometimes called keyhole surgery).
The procedure is similar to other types of lumbar spine surgery such as lumbar spinal decompression surgery or a laminectomy, but uses small incisions (cuts) and a microscope to perform the procedure. This means it has a faster recovery time and a lower risk of complications than traditional surgery.
The two main types of lumbar spine microsurgery are microdiscectomy and microdecompression.
Microdiscectomy works by removing part of a herniated (bulging) disc that is putting pressure on your spinal nerves, irritating or inflaming the nerve root, and causing symptoms such as pain, numbness and weakness in your lower back and legs. Microdecompression works by removing a small part of a vertebra, again reducing pressure on your spinal nerves. A spinal microsurgery procedure may involve removing elements of both a vertebra and a spinal disc.
Call or book online today to arrange a consultation to discuss private lumbar spine microsurgery treatment with a consultant of your choice at Circle Health Group.
This page explains what lumbar spine microsurgery is, why you might need lumbar spine microsurgery and what happens during the procedure.
Your consultant may recommend lumbar spine microsurgery if you are experiencing difficult symptoms due to compression of the nerves in your lower back. It is usually only considered when other treatments haven’t worked.
Your spine is made up of small bones called vertebrae that surround and protect your spinal cord and nerves. These bones are positioned on top of each other to form your spinal column. Soft cushioned discs sit between the vertebrae to act as shock absorbers and prevent your vertebrae from rubbing against each other. A prolapsed or herniated disc occurs when one of these discs bulges out and puts pressure on the nerve root, causing symptoms such as back pain, muscle spasms, leg pain (sciatica), leg weakness, numbness and in some cases, difficulty controlling your bladder or bowels. Similar symptoms can also be caused by the vertebrae pressing on your nerves.
The main benefit of lumbar spine microsurgery is relief from symptoms such as back and leg pain and leg weakness. Lumbar spine microsurgery offers an 80-90% chance of significant pain relief, allowing greater mobility, and leading to an improved mood and quality of life.
Some benefits of lumbar spine microsurgery over traditional lumbar spine surgery include:
- Faster recovery and return to normal activities including work and exercise
- Less pain after surgery
- Greater accuracy and less damage to the surrounding tissues
- Less scarring
- Reduced risk of postoperative complications such as infection and bleeding
Some non-surgical alternatives to lumbar spine microsurgery include painkillers, anti-inflammatory medications, epidural steroid injections and physiotherapy. Your consultant will normally only suggest surgery if these alternatives have not been successful in improving your symptoms.
Alternative surgical procedures include open spinal surgery, such as open lumbar laminectomy or open discectomy.
At your first consultation, you will usually be seen by a consultant spinal neurosurgeon, a doctor specialising in performing operations on the spinal cord.
Your consultant will ask you about your symptoms, general health, medical history, and any medications you take regularly. They will ask you about any treatments you have tried previously and how successful they were. They will perform a physical examination including a thorough neurological examination to check your reflexes, muscle strength, gait (how you walk) and sensation.
Your consultant may order imaging tests such as an X-ray, CT, or MRI scan to examine your spine in detail and identify any abnormalities. They may also perform nerve tests like nerve conduction studies or an electromyogram (EMG) to check how well your nerves are working.
Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. Your consultant will take time to get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your lumbar spine microsurgery, so please discuss any questions or concerns with your consultant during your appointment.
At the end of your appointment, your consultant will decide if lumbar spine microsurgery is a suitable procedure for you based on your symptoms, diagnosis, age and general health. They will explain the procedure to you, including how to prepare for your surgery, what happens during the operation, any potential risks and complications, and what to expect during your recovery.
Your consultant will tell you everything you need to do to prepare for your lumbar spine microsurgery. Instructions on how to prepare will also be in your appointment letter.
If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice.
Pre-operative assessment
Around a week or two before your surgery, you may need to attend the hospital for a pre-operative assessment to make sure you are fit to undergo the general anaesthetic and surgery. Take any medication you take regularly, including over-the-counter medicines and supplements with you to your appointment. At the preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health.
Optimise your general health
Being in the best possible health before your lumbar spine microsurgery will reduce the risk of complications and help speed up your recovery. Prepare for your procedure by being as fit and healthy as possible in the weeks before your surgery. Some things you can do to improve your general health before your surgery include:
- Stop smoking at least eight weeks before your procedure. Smoking increases the risk of complications such as breathing difficulties and infection and can impair wound healing. Your consultant can offer you advice and support with quitting smoking before your surgery
- Follow a healthy, nutritious diet
- Take regular exercise
- Avoid alcohol for a few days before and after your surgery. Alcohol thins your blood and can increase the risk of bleeding during your operation
Regular medications
Your consultant may tell you to stop taking certain medications, such as blood thinners for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure.
On the day of your surgery
On the day of your surgery, take a bath or shower before you arrive at the hospital. Do not apply any products to your skin such as lotions, creams, makeup or perfume. Wear loose, comfortable clothes and flat shoes and leave any valuables and jewellery at home.
You will not be able to eat or drink anything from midnight on the day of your lumbar spine microsurgery.
Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the operation.
Lumbar spine microsurgery is carried out under general anaesthetic meaning you’ll be asleep for the procedure and won’t feel any pain.
Once the anaesthetic has taken effect, your consultant will make a small incision in your lower back. Using a microscope, your consultant will examine the area in detail and identify the issues causing your symptoms. They will then decompress the nerve root using a surgical instrument or laser by removing the part of the vertebra or disc that is putting pressure on the nerve. With lumbar spine microsurgery, only part of the vertebra or herniated disc is removed, allowing for greater accuracy and minimal damage to the surrounding bone and tissue.
Once the surgery is completed, your consultant will close the incision with sutures and apply a sterile dressing over your surgical wound.
Recovering from any type of surgery is a gradual process that is different for everyone. How you recover from lumbar spine microsurgery depends on several factors including your age, general health, the exact procedure you had, and your individual recovery process. You can help your recovery to go more smoothly by being as well informed as possible about what to do after your procedure and following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns.
After your lumbar spine microsurgery, you’ll be taken to the recovery room where the nursing staff will monitor you closely until the effects of the general anaesthetic have worn off. You will then be taken to your room.
You may have some pain or discomfort after your lumbar spine microsurgery. The nursing staff will give you pain medication to manage this.
You may have a small drain in place in your surgical wound to remove any excess blood or fluid after your operation. This is normally removed before you are discharged from hospital.
Once your pain is under control, we’ll arrange for you to have regular physiotherapy sessions during your recovery. Our team of expert physiotherapists will work with you during your recovery to build muscle strength in your back and improve your balance and coordination.
You’ll be given instructions on caring for your surgical wound and when you can take a shower after your surgery.
Once you are discharged, it’s important to increase your activity level gradually. Walking is an important part of your rehabilitation, and you should try to walk a little more each day. Gentle exercise such as swimming, cycling, yoga and Pilates can also be beneficial during your recovery. Listen to your body and stop if you have pain or when you feel tired. Sitting for long periods can cause stiffness, so try to avoid sitting for more than 20 minutes at a time. Avoid heavy lifting for at least two weeks after your lumbar spine microsurgery and avoid bending at the waist as much as possible for three months (you can bend at the knees).
How many nights will I need to stay in hospital?
Depending on your recovery, you may be able to go home later the same day as your lumbar spine microsurgery, or you may need to spend one night in hospital.
Will I be able to drive home?
You will not be able to drive yourself home from the hospital after your lumbar spine microsurgery, or for 24 hours following a general anaesthetic. Please make arrangements for someone to collect you when you are discharged.
How soon can I go back to work?
How long you need to take off work after your lumbar spine microsurgery depends on how well you feel during your recovery and the type of job you do. If you have a sedentary job such as office work, you can expect to return to work around four to six weeks after your surgery. Remember to avoid sitting for long periods and get up and walk around frequently. If you have a more active or manual job, it may be around three months before you can return to work.
When can I drive?
You can drive when you can fully control your vehicle and perform an emergency stop. This is usually a few weeks after surgery. Do not drive while taking strong painkillers, or any other medication that may affect your concentration and impair your reaction times.
When will I be back to normal?
Many people will feel some benefits of surgery such as reduced back and leg pain immediately after lumbar spine microsurgery as the pressure on the spinal nerve root has been removed. Any numbness or weakness in your legs will normally continue to improve for several months after surgery as the nerve root heals.
Most people are fully recovered and able to resume most normal daily activities by around three months after lumbar spine microsurgery.
Lumbar spine microsurgery is a generally safe procedure, but as with any type of surgery, there is a small risk that complications may occur. Your consultant will explain all the possible risks and complications of lumbar spine microsurgery before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and are able to make an informed decision.
Possible complications of any type of surgery include:
- Adverse reactions to the anaesthetic
- Bleeding
- Blood clots in the legs or lungs
- Wound infection
- Damage to nearby structures
- Chest infection
Possible complications of lumbar spine microsurgery include:
- Wound infection
- Blood clots
- Haematoma (a collection of blood under the skin)
- Damage to the nerves in the lumbar spine: May cause loss of feeling (sensation), weakness in the legs and very rarely, loss of bladder, bowel or sexual function
- Increased back or leg pain due to nerve damage
- Recurrence of leg pain due to nerve damage, scar tissue, or another herniated disc
- Leak of cerebrospinal fluid (CSF) due to a tear in the lining which surrounds the spinal nerve roots
- The procedure may only provide short-term relief from symptoms
- The surgery may not be successful in reducing pain, weakness and numbness and improving function
At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about lumbar spine microsurgery, book your appointment online today or call a member of our team directly.
Minimally Invasive Lumbar Discectomy - Johns Hopkins Medicine
Lumbar microdiscectomy - The Walton Centre NHS Foundation Trust
Microdiscectomy (Microdecompression) - Spine Surgery Spine-health
Microdiscectomy - National Library of Medicine
