Microdiscectomy
A microdiscectomy removes the fragment of a herniated disc that is pressing on a nerve in the low back. It is a small operation with a large effect: for leg pain from a herniation that has not settled with time and nonsurgical care, it is one of the most reliably effective procedures in spine surgery.
How the operation works
Through a small incision in the low back, the surgeon uses a microscope or a tubular retractor that spreads rather than cuts the muscle. A small window is made in the bone and ligament, the nerve is gently moved aside, and the herniated fragment is removed. The rest of the disc is left in place to continue doing its job. The operation typically takes under an hour.
Results
Leg pain relief is often noticeable when patients wake up, because the pressure on the nerve is gone. Numbness and weakness improve more gradually as the nerve recovers, and some residual numbness can persist depending on how long and how severely the nerve was compressed. The main long-term risk is a new herniation at the same disc, which occurs in roughly 5 to 10 percent of patients and is more likely with early heavy lifting or smoking.
Recovery
Patients walk within hours and go home the same day. Walking is encouraged from the first day. Bending, lifting more than about ten pounds, and twisting are limited for around six weeks while the disc's outer ring heals. Desk work usually resumes in one to two weeks and physical work by six to twelve weeks. Physical therapy after the first few weeks helps rebuild core strength and protect the disc.
Common questions
Is microdiscectomy the same as minimally invasive discectomy?
Essentially, yes. Both use a small incision and magnification. A tubular retractor makes the approach even less disruptive to the muscle. Dr. Michael uses the minimally invasive technique whenever the anatomy allows.
Will my back pain go away too?
The operation is designed to relieve leg pain from the nerve. Back pain often improves as well, but it is less predictable, and patients with mainly back pain are usually not candidates.
What if the disc herniates again?
A recurrent herniation can often be treated with the same operation. When recurrences repeat or the disc has lost significant height, a fusion or disc replacement may be discussed.