Micro-Lumbar Discectomy For Painful Disc Herniation

Case Report And Review Of Literature

Abstract

Lumbar radiculopathy is a relatively common condition characterised by radiating leg pain due to nerve root compression. The aetiology of compression is typically a herniated lumbar disc. This case report delineates the surgical management of a 56-year-old female presenting with two months of severe, unilateral lumbar radiculopathy, radiating from her lower back to her left leg. Despite trials of pharmacological therapy, the patient experienced no pain alleviation. Magnetic resonance imaging (MRI) revealed a left L4-L5 foraminal disc herniation compressing the exiting nerve root. Micro-lumbar discectomy was selected as the surgical intervention of choice due to its minimally invasive nature, which avoids unnecessary tissue disruption while effectively decompressing the nerve.

Micro-lumbar discectomy involves precise excision of the herniated disc material through a small incision, preserving much of the surrounding bone and soft tissue. In this case, the surgeon employed fine microsurgical techniques to minimise trauma, utilising specialised instruments to navigate the narrow operative field. The procedure was performed under magnification to ensure precise identification and preservation of spinal neuroanatomy, particularly the nerve root and adjacent structures. Postoperatively, the patient experienced immediate and significant alleviation of radicular pain with no neurological deficits.

This case underscores the significance of micro-lumbar discectomy as a superior management option for foraminal disc herniations, offering reduced recovery time and lower complications rates compared to traditional open procedures. A comprehensive understanding of spinal neuroanatomy, combined with advanced microsurgical skills, is critical in achieving successful outcomes. The ability to carefully decompress the nerve root while preserving surrounding tissues is essential for minimising complications and ensuring long-term symptom relief.

In conclusion, micro-lumbar discectomy provides an effective and less invasive treatment for lumbar radiculopathy, emphasising the necessity for both anatomical expertise and surgical precision in spinal surgery.