Abstract

Removal of a herniated disc with the use of of bone (the lamina) from the affected vertebra may be Lumbar herniated nucleus pulposus (HNP) the operative microscope was first removed. This is called a laminotomy or laminectomy. Generally has an acute onset often without a performed by Yasargil in 1977. However, it It allows the surgeon to better see the herniated disc. precipitating event. Unless there is a significant or began to be used more and more only in the late 1980s Microdiscectomy uses a special microscope to emergent neurologic deficit, nonsurgical medical The merits of this technique are that it allows every view the disc and nerves. This larger view allows the management is warranted for 6 or more weeks after type of disc herniation to be excised through a short surgeon to use a smaller cut. This causes less damage the onset of symptoms. If there is no improvement in 6 approach to skin, fascia and muscles as well as a to surrounding tissue. weeks, surgical intervention may be indicated. limited laminoarthrectomy. For these reasons, it has During discectomy, the surgeon removes the part Microdiscectomy is the gold standard treatment for been, and still is, considered the "gold standard" of of the disc that is herniated and is pushing into the uncomplicated HNP. surgical treatment for lumbar disc herniation, and the spinal canal. Any loose fragments of disc are also A microdiscectomy is performed through a small (3- method used by the vast majority of spinal surgeons. removed. 4 cm) incision in the midline of the low back. Discectomy is surgery to remove herniated disc Microdiscectomy is still the standard method of First, the back muscles (erector spinae) are lifted material that is pressing on a nerve root or the spinal treatment due to its simplicity, low rate of off the bony arch (lamina) of the spine. Since these cord. complications and high percentage of satisfactory back muscles run vertically, they can be moved out of Before the disc material is removed, a small piece results, which exceed 90% in the largest series the way rather than cut.