Lumbar discectomy is the most common elective surgery for degenerative lumbar spine lesions. The rates of good and excellent outcomes are as high as 90–95%. Intervertebral disc prolapse occurs because of the tear in the annulus fibrosis and through which jelly like center portion called nucleus pulposis comes out and causing pressure over the nerve roots. Low-back pain causes nearly 80% of injured workers to miss at least 8 weeks of work following a back injury. In persons younger than 45 years old, low-back pain is the most frequent cause of activity limitation. Apart from nonspecific back pain, degenerative disease and disc herniation represent the most common causes for LBP-related physician office consultations. In fact, the majority of lumbar radicular pain symptoms are the result of a disc herniation, defined as bulging of the nucleus pulposus through a fissure or tear within the annulus fibrosus. Although favorable outcomes have been demonstrated for both surgical and nonoperative treatment options, patients who underwent open discectomy for lumbar disc herniation (LDH) were shown to have better self-reported outcomes than conservatively treated individuals.
In the present case procedure is done under general anesthesia in prone position on a Bolster or under Wilson’s frame with a flat table. Skin incision was made than a lumbo-sacral fascia was cut with the help of electro cautery. Under the microscope paraspinal muscle was stripped off lamina with the help of periosteal dissector (Cobb’s dissector) upper 2/3rd of the lamina and medial part of the facet joint cut with bone scalpel. Sharp cutting incision is seen in lamina and medial facet. Square shaped incision was made in the disc with the help of No. 15 blade and disc is removed in piece meal or as a big piece if sequestrated. Haemostasis was achieved and patties were removed. Patient is made seat and walk after 6 hours of surgery. Patient is discharged on the next day morning with follow up after 7 days with oral medicines. Micro lumbar discectomy is commonly used very safe procedure, providing direct 3D vision and very effective in relieving the symptoms (98%) of the patient. It minimize the hospital stay and hence reducing the cost of hospitalization and patient can go on his/her duty earlier.
