3D-microsurgery
The patient is brought into the operating room and is put under general anaesthesia lying on his/her stomach. A fluoroscope sends x-ray pictures onto a screen to localize the afflicted level. The patient's back is soaped to create a sterile area. Sheets are placed before surgery begins.
A half to one-inch incision is made. A small part of the muscle is shifted aside. The 3D-microscope is put in position. The lamina are exposed in order to access the nerve; this roof of bone must be removed partially which can be done with a small, high-speed drill or a small bone-biting tool called a Kerrison rongeur. The bone covers the nerve, as it is about to exit the spine. By removing the bony cover, the nerve can be exposed and then removed safely. After the bone has been removed, the yellow ligament (a rubbery layer of tissue) can be seen which protects the underlying nerves.
Great care is taken when separating and removing the yellow ligament, exposing the thecal sac and the exiting nerve root. Ruptured disc material has a consistency similar to an uncooked shrimp. When a small puncture is made into the tissue covering the disc, the disc will often times begin to ooze out. Various tools are used to remove the ruptured disc and other loose fragments of disc in the surrounding area.
No attempt is made to remove the entire disc at that level - that is what is supporting those vertebrae. When completed, the small hole will fill in on its own.
