Microdisketomy

Often, adequate decompression of the spinal cord or nerve root can be achieved by microdiskectomy. In this procedure, a hemilaminotomy (partial removal of the disc) is done through a tiny skin incision, and herniated disk material is removed with the aid of an operating microscope.

Microdiskectomy is basically the same procedure as a laminotomy, but an operating microscope with special small tools are used. With this method, the soft tissue damage and trauma of surgically approaching the herniated disc is significantly reduced, which also reduces the post-operative morbidity. It usually only requires one or two days in the hospital. The drawback of both this method and the laminectomy is that in order to remove the protruding disc material, the protective posterior ligamentous portion of the annulus fibrosus (the capsule) and posterior longitudinal ligaments usually must be surgically cut. In that case, there is a weakness created that can allow for future degenerated disc material to re-enter the spinal canal space through the surgically cut ligaments. For that reason, I would advocate these procedures only for those instances when the disc material has actually already herniated through the posterior ligamentous capsule, which can be determined when a discogram reveals the dye escaping through the torn capsule. If it hasn't, then a logically better approach might be to attempt a percutaneous diskectomy because that will better maintain the integrity of the capsule. It that fails, then an open approach might prove necessary, later; but, the trial with the percutaneous route stands a much greater probability of never requiring open surgery especially if the PRINCIPLES in this book are adhered to post-surgically because The O'Connor Technique (tm) reduces the pressure and consequently the probability that disc material will put enough pressure on the posterior ligamentous structures to result in a herniation.

Further Reading

Introduction
TENS (Transcutaneous Electrucal Nerve Stimulation)
Ice and Heat
Acupuncture
Trigger Point Point Injections
Epidural Steroid / Aneshetic Injections
Chemonucleolysis
Surgery
Percutaneous Diskectomy
Microdiskectomy
Laminectomy
Artificial Discs
Fusion

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