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Microlumbar Discectomy

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The aim of operation is decompression of the nerve root. Under general anesthesia a 1 inch incision is made in the low back overlying the nerve root. Using the operative microscope a small crescent of bone is removed from the spine, exposing the nerve root and herniated disc material (laminotomy). The disc material compressing the nerve root is removed and the underlying central disc space is curretted free of retained, degenerated disc nucleus (discectomy).

  • Soon after your surgery, the physiotherapist will see you in your room.
  • Exercises are started to improve your body circulation, circulation of operated part.
  • This helps to reduce post-operative swelling, lung complications and prepares you to start your movements and early ambulation.

Day  0

A)    Physiotherapist will guide you to perform simple lower limb exercises  in bed.

·         Calf pump exercises.

·         Straight leg raising.

·         Taking your leg sideways.

·         Bending your knees.

·         Back press exercises in bed.

·         Tummy tuck exercises in bed.

B)    Nursing staff or physiotherapist will help you to turn on either sides with pillows kept in between the legs. Avoid twisting movements at back (Log Rolling Technique).

C)    Deep Breathing exercises.

D)    Application of Ice Packs / cryotherapy  around the operated site is given to reduce your post-operative pain.

These exercises should be done in set of 5, twice a day along with application of ice packs twice- thrice / day.

Day  1

A)    Same set of exercise is continued.

 

B)    Buttock lifting exercise is taught.

 

C)    Turning to either sides is reviewed and eased.

D)    You would be made to sit with lumbar brace fracture laying down position.  Today you will allowed to sit upright with brace for all your meal sessions for about 10-15 minutes each time.

E)    If there are no complications, you would be made to walk with brace with minimal support in the evening sessions.

F)    Ice packs / cryotheraphy is continued

Day  2

A)    Same set of exercise is continued.

B)    Dynamic back extension exercises in prone is taught.

C)    Sitting time and walking distance is improved.

D)    Toilet training is given.

Day  3

A)    Same set of exercise is continued.

B)    Independent sitting & walking is encouraged.

C)    Stair case climbing is given.

DISCHARGE  :

A)    Discharge is planned when

·         You are able to get out of bed unaided.

·         You are able to walk to the toilet.

·         You are able to sit and get up comfortably on your own.

·         You do not have any other complaints.

B)    On discharge, if for shorter distance you can drive your vehicle with support in place and seatbelts faster. If for longer distance, you are allowed to ride in a regular car with pillows.

·         Knee to chest position.

·         Dynamic back extension in prone.

·         Cat-Camel exercises.

C)     Return to your work

If you do a sedentary job mainly involving sitting and light work, you may resume it by now.

It may be good idea to join part-time at 4 weeks and than progress to full time by 6 weeks.

Avoid sitting for too long at a stretch. Get up and walk around suggestive of you change position.

D)     Sexual activities

They can be resumed as per comfort level by now.

E)     Sitting, walking can be increased in duration & frequency.

Sleep on stomach is permitted by now.

6  – 8 -  12 weeks post  surgery

I.  Activities

Side bending, rotations, and multi-directional activities can be initiated as per comport level. Lifting weight upto 20 pounds permitted.

II. Exercises

Vigorous exercises plan will  be incorporated.

Core stabilization exercises.

Dynamic abs – back exercises on ball.

Can start with gym - lighter exercises regimen - heavier exercises regimen.

III. Return to work :

If  you have jobs that involve prolonged sitting with minimal lifting till about 20 pounds can be initiated by now.

IV. Sitting, standing, walking should be according your comfort level. Treadmill, stationary bicycle, swimming can be started.

12  – 24 weeks post  surgery

I.  Activities

Full release of all activities at this time.

Most of restrictions are lifted by this time.

Lifting, stooping, side bending can gradually  be progressed.

II. Return to work :

Heavy labourous work may be resumed with some minor modifications.

III.  Sports

Sports can be started by now preceding a functional training exercises   programme.

Jogging causing be initiated by bow.

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