Microdiscectomy: Minimally Invasive Herniated Disc Surgery

A microdiscectomy is a minimally invasive surgical procedure designed to relieve nerve pain caused by a herniated disc in the lower back. Using advanced magnification technology, the surgeon removes only the portion of the disc pressing on spinal nerves—providing targeted relief while preserving the majority of the disc and surrounding structures.

How Microdiscectomy Works

The procedure involves removing herniated disc material that compresses the spinal nerve root, relieving pain that radiates down the leg (sciatica). A small incision of 1-2 inches is made in the lower back, and surrounding muscles are gently retracted rather than cut. The surgeon uses a microscope or surgical loupes for enhanced visualization, allowing precise removal of the herniated portion while protecting nerve structures.

Conditions that often benefit include:

Lumbar herniated disc causing leg pain or sciatica
Nerve root compression unresponsive to conservative treatment
Weakness or numbness in the leg or foot
Pain lasting more than 6 weeks despite physical therapy and medication

Step-by-Step Procedure

Preparation
The procedure is performed under general anesthesia with patients positioned lying on their stomach. Intraoperative X-ray imaging confirms the exact disc level before beginning.

Surgical Approach
A 1-2 centimeter incision is made in the midline of the lower back directly over the affected disc. Back muscles are lifted and retracted to the side without cutting, minimizing tissue damage.

Disc Removal
The surgeon removes a thick ligament (ligamentum flavum) covering the nerve roots and may trim a small portion of bone to access the herniation. Using specialized instruments, only the herniated fragment is removed while the majority of the disc remains intact.

Closure
Muscles are repositioned naturally, and the incision is closed with sutures and surgical strips. Most procedures take 60-90 minutes and are often performed on an outpatient basis.

Key Benefits of Microdiscectomy

Targeted nerve decompression with immediate pressure relief
Minimally invasive approach with 1-2 inch incision
Preservation of spinal stability—joints, ligaments, and most disc tissue remain intact
Faster recovery compared to traditional open discectomy
High success rate for relieving leg pain and restoring function
Same-day or overnight hospital stay in most cases

Recovery and Aftercare

Most patients can walk the same day of surgery and return home within 24 hours. Mild soreness at the incision site is normal and can be managed with prescribed pain medication. Avoid bending, lifting, or twisting for the first 2-3 weeks to allow proper healing. Physical therapy typically begins 2-4 weeks post-surgery to restore strength and flexibility. Most patients return to desk work within 2-3 weeks and physical labor within 6-8 weeks.

Possible Risks and Side Effects

Though uncommon, potential complications include:

Recurrent disc herniation (5-10% of cases)
Nerve root injury or persistent numbness
Infection at the surgical site
Cerebrospinal fluid leak (dural tear)
Blood clots or bleeding

Contact your surgeon immediately if you experience fever, increasing pain, drainage from the incision, or new weakness in your legs.

Related Conditions and Treatments

Microdiscectomy is often recommended when conservative treatments have not provided lasting relief for herniated disc symptoms.

Your care team may also discuss or combine with:

Lumbar Spinal Stenosis: When spinal canal narrowing contributes to nerve compression

Epidural Steroid Injection: A non-surgical option that may be tried before surgery

Spinal Disc Decompression: Non-surgical therapy for disc-related pain

These related treatments help you explore the full spectrum of options from conservative care to surgical intervention.

Is Microdiscectomy Right for You?

This surgery is typically considered when:

Leg pain is more severe than back pain
Conservative treatments (physical therapy, medications, injections) have failed after 6-12 weeks
Nerve compression causes progressive weakness or numbness
Imaging (MRI) confirms a herniated disc correlating with symptoms

A consultation with a spine specialist will determine if microdiscectomy is appropriate based on your specific condition, symptoms, and treatment goals.