Microsurgical Treatment of Herniated Discs

Written by Kevin T. Foley, MD

Minimally invasive procedures incorporating microsurgical techniques have impacted virtually every surgical field. These techniques have become the standard of care for surgeries involving the joints and the gastrointestinal tract. Now they are being adapted to treat certain spinal disorders today!
Most people are familiar with arthroscopic surgery. This type of surgery is used to work inside joints such as the knee with minimal disruption of surrounding tissues. Arthroscopic surgery is minimally invasive and uses video cameras and specially designed instruments. During the last 10 years, spine specialists have worked to develop new minimally invasive techniques, tools and instruments to refine a form of ‘arthroscopic’ surgery for the spine.

The purpose of this article is to provide patients with information about an exciting new microsurgical system used to remove herniated discs from the cervical or lumbar spine. Continue reading to learn more about this minimally invasive technique.

Herniated Discs
A herniated disc in the lumbar spine can cause numbness, tingling, weakness and/or pain that extend from the back into one or both legs. A herniated disc in the cervical spine can cause similar symptoms that extend from the neck into one or both arms. These are neurological symptoms. In other words, the ruptured disc may be pinching or compressing one or more spinal nerve roots. Sometimes the symptoms are so severe that activities of daily living are limited. Fortunately, most patients respond well to medication, physical therapy and time. Surgery only needs to be considered if significant symptoms persist despite a good trial of nonsurgical treatment.

Spine Surgery: Then and Now
Traditionally, spine specialists have used an open approach to remove a herniated disc. The procedure is called a discectomy. In standard open discectomies, the attached muscles are stripped or scraped off the bony portion of the spine to enable the surgeon to see the herniation. During surgery, the affected nerves are decompressed as offending disc fragments are removed.

Today, using the METRx™ System, spine surgeons are able to perform a cervical or lumbar discectomy using minimally invasive surgical techniques. METRx™ stands for Minimal Exposure Tubular Retractor. The METRx™ System is an extension of the MED technique and uses a minimally invasive surgical approach to the spine that places a small tubular retractor between the muscle fibers. The muscles are not scraped away from the bones of the spine, but stay attached to it. The surgeon uses a microscope or an endoscope to look through the small tubular retractor to visualize the pinched nerve root. The root is then decompressed using special microsurgical instruments.

Copyright Medtronic Sofamor Danek. Used by Permission.

In terms of relief of symptoms related to unpinching the nerve root, the surgical outcome using METRx™ is comparable to an open procedure. However, since the METRx™ System allows the surgeon to unpinch the root through a small tube placed between the muscle fibers, it offers patients several advantages:

In any type of surgical procedure, surgery is the first step in recovery. Thereafter, healing begins naturally. You can enhance the healing process by following your physician’s orders, which may include avoidance of tobacco, a healthy balanced diet, physical therapy and exercise, and rest.

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