Microdiscectomy in Elizabethtown, Kentucky
Sciatica that shoots from the lower back down one leg is one of the most common reasons Hardin County patients come to Aptiva Health’s Elizabethtown clinic. Most of it gets better without surgery. For the minority of herniated discs that do not, microdiscectomy is a short, minimally invasive operation with a long track record of relieving leg pain. Dr. Michael Casnellie, a board-certified spine surgeon, evaluates spine patients at 529 Westport Road, Suite 2, and your pre-operative visits, follow-ups and physical therapy stay in Elizabethtown.
Call 270-506-4888. Monday through Friday, 8 AM to 5 PM. Same-day appointments available.
Schedule your appointment today!
Is microdiscectomy right for you?
A lumbar disc herniation happens when the soft center of a disc pushes through its outer wall and presses on a nerve root. The result is less often back pain than leg pain: a burning or electric ache down the buttock, thigh and calf, sometimes with numbness, tingling or weakness in the foot. The most common levels are L4-5 and L5-S1.
Microdiscectomy is usually considered when:
Leg pain has lasted six weeks or more despite medication, activity modification, physical therapy and, often, an epidural steroid injection
An MRI shows a herniation at the level that matches your symptoms
Pain is severe enough to limit work, sleep or daily activity
There is progressive weakness in the leg or foot
Two situations are urgent rather than elective: new weakness that is getting worse, and any change in bladder or bowel control with numbness in the saddle area. Those need same-day evaluation; call 270-506-4888 or go to an emergency department.
Patients whose main complaint is back pain rather than leg pain, or whose MRI findings do not match their symptoms, are generally not candidates and do better with non-surgical care.
What we try first, in Elizabethtown
About nine in ten disc herniations improve within three months without surgery. The Westport Road clinic delivers the full non-surgical pathway:
Medication and a short period of modified activity, staying as active as pain allows rather than bed rest
Physical therapy with Simon Hoehn, PT, DPT and Dovie Brown, PTA, using directional-preference exercises, core stabilization and nerve-gliding techniques; Dovie works one on one with patients and has extensive experience with orthopedic injuries and conditions
Epidural steroid injections, performed by our interventional pain team, which can shorten the painful phase and sometimes avoid surgery entirely
Your surgeon reviews your progress at follow-up visits in Elizabethtown and recommends surgery only if the pain is not resolving on its own.
Your first visit at Westport Road
Where: 529 Westport Road, Suite 2, Elizabethtown, KY 42701. Parking at the door.
When: Monday through Friday, 8 AM to 5 PM; same-day appointments available at 270-506-4888.
What happens: history, a neurological exam of strength, sensation and reflexes, straight-leg-raise testing, and on-site X-rays to check alignment and rule out other causes.
MRI: if needed, it is scheduled at Aptiva Health Imaging, 3615 Newburg Road in Louisville, and reviewed with you at your next Elizabethtown visit. Bring any MRI you already have on disc.
Bring: photo ID, insurance card, medication list, prior imaging, and claim details for work or auto injuries.
Surgery day
Microdiscectomy is performed under general anesthesia through an incision about one inch long. Using an operating microscope, the surgeon moves the muscle aside, removes a small window of bone or ligament if needed, and takes out the disc fragment pressing on the nerve. The rest of the disc stays in place. The operation typically takes about an hour.
For Elizabethtown patients, surgery is performed in the Louisville metro area. Most microdiscectomies are outpatient; you walk the same day and go home within a few hours. All planning for surgery day happens at your Elizabethtown pre-operative visit.
Recovery and physical therapy in Hardin County
Day of surgery: up and walking. Leg pain is often dramatically better immediately; some incision soreness is normal.
Weeks 1 to 2: walking daily, no lifting over about ten pounds, no prolonged sitting. First follow-up at the Elizabethtown office.
Weeks 2 to 6: physical therapy begins at Westport Road. Desk work usually resumes within one to two weeks.
Weeks 6 to 12: progressive return to lifting, driving long distances and physical work. Heavy labor is usually cleared at about three months.
Numbness can take months to fade and occasionally persists even when pain is gone. The risk of the same disc re-herniating is roughly 5 to 10 percent, which is why the lifting and bending precautions in the first weeks matter.
Why Elizabethtown patients choose Aptiva Health for spine care
One spine team, one chart. From your first visit through injections, surgery and rehab, your surgeon, the Westport Road clinic team and your physical therapists share one record and one plan.
Conservative care first. About nine in ten disc herniations settle without surgery, and we deliver therapy, medication management and epidural injections in Elizabethtown before any operation is considered.
Same-day appointments. The Westport Road clinic sees new spine patients Monday through Friday, 8 AM to 5 PM. Call 270-506-4888.
Follow-up close to home. Pre-operative planning, wound checks, follow-up visits and physical therapy with Simon Hoehn, PT, DPT and Dovie Brown, PTA all happen in Elizabethtown.
Risks and realistic expectations
Microdiscectomy carries the general risks of surgery, including infection, bleeding, a tear of the membrane around the nerves that may cause a temporary headache, nerve injury, and anesthesia complications, plus the specific risk of recurrent herniation. Leg pain relief is the most reliable benefit; back pain improvement is less predictable. Your surgeon will go through these risks with you before you decide.
Your Elizabethtown spine surgeon
Spine patients at Aptiva Health’s Elizabethtown clinic are evaluated and treated by Michael Casnellie, MD, a board-certified spine surgeon, with physical therapy on site from Simon Hoehn, PT, DPT and Dovie Brown, PTA. Your surgeon and therapy team share one chart, so your rehab follows your surgical protocol.
Dr. Michael Casnellie has been treating spine patients in Kentucky since 2005 and is one of the most experienced motion-preservation spine surgeons in Kentucky. He performed Kentucky's first Mobi-C cervical artificial disc replacement — a procedure that preserves motion at the affected level of the cervical spine instead of fusing it — and remains one of the few surgeons in the state offering both cervical and lumbar disc replacement to appropriate candidates.
He sees spine patients at Aptiva Health’s Elizabethtown clinic on Westport Road.
Insurance accepted
Aptiva Health accepts most major insurance plans, Medicare, Medicare Advantage, most Kentucky Medicaid plans, workers’ compensation, and auto injury coverage (PIP and MedPay). We verify your benefits before surgery and explain your expected costs. We offer self-pay where there is no insurance, it is a non-covered service, and on a case-by-case basis.
Call 270-506-4888 to verify your insurance.
Get evaluated in Elizabethtown
If leg pain, numbness or weakness from a herniated disc is not settling with conservative care, it is time to talk to a spine surgeon. Aptiva Health Orthopedics, Elizabethtown: 529 Westport Road, Suite 2, Elizabethtown, KY 42701. Phone 270-506-4888. Monday through Friday, 8 AM to 5 PM. On-site X-ray. Same-day appointments available.
Physical therapy at Westport Road is provided by Simon Hoehn, PT, DPT and Dovie Brown, PTA. Dovie works one on one with patients and has extensive experience treating orthopedic injuries and conditions. Epidural steroid injections are performed in Elizabethtown by our interventional pain team.
MRI, when needed, is scheduled at Aptiva Health Imaging, 3615 Newburg Road, Louisville, KY 40218, and reviewed with you at your next Elizabethtown visit.
Frequently asked questions about microdiscectomy in Elizabethtown
Do I have to go to Louisville for microdiscectomy?
Your evaluation, pre-operative visit, follow-ups and physical therapy are all at our Elizabethtown clinic on Westport Road. The surgery itself is performed in the Louisville metro area, usually as an outpatient procedure, and you return to Elizabethtown for all follow-up care.
How long before I can go back to work?
Most patients with desk jobs return within one to two weeks. Physically demanding jobs usually wait six to twelve weeks, depending on your progress in therapy. Your surgeon sets the timeline at your Elizabethtown follow-ups.
Can I get my injections and therapy in Elizabethtown?
Yes. Epidural steroid injections and physical therapy with Simon Hoehn, PT, DPT and Dovie Brown, PTA are all provided at the Westport Road clinic.
Will I need an MRI before my first appointment?
No. You will be examined and X-rayed in Elizabethtown first. If an MRI is needed, it is scheduled at our Newburg Road imaging center in Louisville and reviewed at your next Elizabethtown visit.
How quickly can I be seen for sciatica?
Same-day appointments are available Monday through Friday, 8 AM to 5 PM. Call 270-506-4888. New weakness or any change in bladder or bowel control should be evaluated the same day.