Microdiscectomy

Rick B. Delamarter, MD

Material Covered:

Over the past 15 years, microdiscectomy techniques have been developed in an effort to reduce tissue trauma and speed up the recovery process after lumbar disk surgery. In the past, a large 4- to 5-in incision was used to perform discectomies and laminectomies where the majority of the lamina was removed, resulting in fairly extensive recovery times. Now the surgeon can treat most lumbar disk herniations with a microsurgical discectomy through a small 1- or 1.5-in incision. In coordination with the microsurgical procedure, Dr. Delamarter is employing a ligamentum flavum-sparing approach. By keeping the ligamentum flavum intact, nerve root manipulation and postoperative epidural fibrosis are both minimized. By retracting the ligamentum flavum and nerve root, and performing the proper bony removal, excellent exposure of the disk herniation can be achieved. Critics of this procedure often complain about the missed pathology. Dr. Delamarter feels that it is necessary to have a proper understanding of the offending pathology in order to properly remove any structure that may pinch the nerve roots. This introduces a significant learning curve into the microdiscectomy procedure.

References
1. Abernathey CD, Yasargil MG Results of microsurgery In: Microsurgery of the Lumbar Spine Rockville, Md: Aspen 1990:223-226
2. Hudgins WR The role of microdiskectomy Orthop Clin North Am 1983;14:589-603
3. Wilson DH, Kenning J Microsurgical lumbar diskectomy: Preliminary report of 83 consecutive cases Neurosurgery 1979;4:137-140

Specifications

• Total Run Time: 18:39 minutes
• Catalog Number: 8012
• VJO Publication Date: October, 1994