Overview of Procedure
Typically, a small incision is made over the lower back to access the disc material and spinal canal. A portion of the lamina, the back of the vertebrae forming the spinal canal, is removed to facilitate access. Through this opening, the nerve is safely retracted, and the herniated disc material is removed. The procedure usually lasts 45 minutes to 2 hours and is often performed on an outpatient basis. Minimally invasive techniques using small tubes are common to reduce incision size and preserve surrounding back muscles.
Recovery
Dressings can be changed daily starting the second day post-surgery, with showers permitted between dressing changes. If an Aquacel dressing is used, showers are allowed from the first day post-surgery, and the dressing can remain in place for up to a week. Until the incision is fully healed, avoid submerging it in water (bathtub, swimming pool, etc.) to prevent infection.
Walking is encouraged, while bending, lifting, and twisting should be avoided for the first 4 weeks. Sedentary job holders can often return to work within 1 to 2 weeks, while more physically demanding occupations may require 4 to 6 weeks off.
Physical therapy may be recommended to help regain leg strength and range of motion during recovery. Follow-up appointments are typically scheduled for 2- or 3- weeks post-surgery and again around 6 weeks, after which full activity can resume with no additional office visits needed. Driving can be resumed once narcotic pain medication is no longer needed, typically within a week.