Microdiscectomy and/or rhizolysis

Left part of K

Find out more about microdiscectomy and/or rhizolysis, a procedure to remove part of a protruding disc. 

Microdiscectomy and/or rhizolysis key points

  • A microdiscectomy is a procedure whereby we remove only a small part of a bulging disc that is pinching a spinal nerve.
  • Rhizolysis means to remove whatever is pinching the nerve, which could be the disc, but also other arthritic tissue, even a cyst.
  • Microdiscectomy is one of the most common and most successful keyhole operations performed by spine surgeons around the world. Once the nerve has been decompressed, the pain often disappears immediately.

Microdiscectomy and/or rhizolysis | Spine surgery Brisbane

The surgeon said microdiscectomy and/or rhizolysis. What exactly is that?

Microdiscectomy is a fancy surgical term to describe shaving off part of the disc. Often it is only about 2-5% of the disc that is getting shaved off, with the remainder of the disc left completely alone. It is a keyhole operation. 

Rhizolysis is a funny term that basically means to remove whatever is pinching the affected spinal nerve. This could be disc material, in which case my report would read ‘microdiscectomy and rhizolysis’. But it could also be other arthritic tissue (like bone or ligament), or even a small spinal cyst. Once the nerve has been decompressed the pain and symptoms often disappear immediately.

These terms can be applied to both the neck and lower back, however the operation is more common in the lower back.

Microdiscectomy success rate

Is it successful?

Yes, it is.

It is one of the most reliable and successful operations performed by spine surgeons around the world. Most surgeons get consistently excellent results for patients. 

The vast majority of patients that go through this operation are very happy with the result. The goal of microdiscectomy or rhizolysis surgery is to improve your quality of life. For some that’s being pain-free, for others it means being able to walk and move freely again, or being back on the golf course. 

I will consider all the important factors with you and determine what is best for you and the quality of life that you want to achieve.

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Spinal surgeon Brisbane

 

You will have a general anaesthetic to knock you out for the whole surgery. Then I make a small incision in the lower back, usually about 1 inch or smaller. I’ll insert a fibre optic tube (between 15-18 mm in width) gently between the muscles of your lower back down to the spine (usually about 5-7cm deep). I then look down this tube with a microscope under high magnification and gently remove the small portion of disc or arthritic tissue off the nerve. Once the nerve is completely free, the tube is removed, the small incision closed, and you are woken up. 

Microdiscectomy risks

Is it safe?

Yes, it is.

Many patients choose to go home within 12-18 hours after surgery because they feel fine, with a small incision about 1 inch long. It is not like in the past where the surgeries were very big and invasive, with really long recovery times. New techniques have vastly improved this operation, making the surgery smaller, and the recovery more rapid.

With all this in mind the risks I will discuss with you are:

  1. Your symptoms may not improve or they may reoccur several weeks or months down the track. This is now quite rare. Most patients get excellent relief of their symptoms for good.
  2. Nerve damage. Fortunately it is very rare nowadays to get nerve damage from this type of surgery.
  3. Bleeding. This is rare.
  4. Infection. This is rare in modern surgical practice:
    • Antibiotics. When these were invented in the 1940s, surgery was utterly transformed.
    • Proper skin care during and after surgery. Healthy skin is a vital barrier to infection: ‘If you look after the skin, the skin will look after you!’
    • Shorter surgery. While there is no cut-off point, it is well recognised that the more efficient the surgery, and the less time taken, the lower the risk.
  5. General risk of the anaesthetic like clots in the legs, clots in the lungs, urinary tract infections, skin injuries from being on a bed for a long time, and heart or kidney problems. Modern anaesthetic medicine makes many of these risks very low.

I am committed to getting the best possible result for you and minimising the risks. This also includes keeping regular contact with you during the recovery phase.

Microdiscectomy recovery

What can and can't I do afterwards?

You will be surprised to learn how much you are allowed to do straight after surgery. It is very important to get your confidence back as soon as possible and that’s why I will encourage you to be as active as possible. So recovery doesn’t mean “just resting”. 

I always say to everyone in front of me: Recovery is like compound interest; if you do the time, you’ll get the best result. If you shortchange yourself and bail out early you will miss out on significant benefits long term. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Spinal surgeon Brisbane

So to get the best results you need to commit to a full recovery period and this includes being active. 

Spinal surgeon Brisbane

What else do I need to know?

If you would like me to assess your condition please contact my team to book an appointment. 

Ready to make an appointment?

Alex consults at Queensland Neurosurgery & Spine Surgery (QNS).
Dr Alex Koefman

Ramsay Specialist Centre
Suite 325
Newdegate St
Greenslopes QLD 4120

Phone
Fax

(07) 3397 4185

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