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Microdiscectomy

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Abstract

Microdiscectomy is the commonest spinal operation and the one that produces the most reliable outcomes from spinal surgery. The origins of the procedure are discussed from the time that disc herniations were mistaken for some form of chondral tumour to the proper identification of the pathology by Mixter and Barr in 1934. The natural history of disc herniations is outlined together with the clinical syndrome of back pain, sciatica and neurological dysfunction. As sciatica can resolve spontaneously with resorption of the herniated disc material a conservative approach to treatment is often possible with medications, perineural steroid injections and physiotherapy providing enough comfort to help the patient to manage the condition whilst buying time for the natural healing process to occur. There are absolute and relative indications for surgical intervention. Details of simple microdiscectomy techniques are shown, which are highly effective without the need for sophisticated instrumentation. Tips are given to improve level localisation and ensure that the procedure can be carried out safely through a small approach with minimal retaction. Complications and their avoidance are discussed.

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  1. Department of Orthopaedic Surgery, Royal Berkshire Hospital, Reading, UK

    Trichy S. Rajagopal & Robert W. Marshall

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  1. Trichy S. Rajagopal
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  2. Robert W. Marshall
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Correspondence to Robert W. Marshall .

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  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

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Rajagopal, T.S., Marshall, R.W. (2014). Microdiscectomy. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_89

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