Microdiscectomy is a type of spine surgery used to treat a herniated disc in the lower back when it presses on a nearby nerve. It is usually done to relieve leg pain, numbness, tingling, or weakness caused by lumbar radiculopathy, which is often called sciatica.
During microdiscectomy, the surgeon removes the small part of the disc that is pressing on the nerve. The goal is to reduce nerve irritation, improve symptoms, and help the person return to daily activities with less pain.
This surgery is usually considered when symptoms do not improve with non-surgical treatment, or when nerve symptoms are severe. Recovery can vary, and medical follow-up is important to monitor healing, reduce the risk of complications, and guide a safe return to work, exercise, and normal activities.
When it is indicated
Microdiscectomy may be indicated for a lumbar herniated disc that causes pain, numbness, tingling, or weakness that travels from the lower back into the buttock, leg, or foot. These symptoms happen when disc material presses on a spinal nerve.
This surgery is usually considered when symptoms continue after conservative treatment, such as medication, physical therapy, rest, or activity changes. It may also be considered sooner when there is severe pain, worsening weakness, or signs that the nerve is not working properly.
The best timing for microdiscectomy depends on symptom severity, overall health, imaging results, and how much symptoms affect daily life. Some studies suggest that a longer duration of symptoms before surgery may be linked to less improvement after surgery, although many people still improve.
How to prepare
Preparation for microdiscectomy usually includes a medical evaluation, physical exam, and imaging tests, such as MRI, to confirm that a herniated disc is pressing on a nerve. The surgeon may also review the person’s symptoms, medications, allergies, and past medical history.
A preoperative risk assessment may be recommended, especially for people with diabetes, obesity, smoking history, heart disease, or other health conditions. These factors can affect healing, infection risk, and the chance of needing another procedure.
Before surgery, the medical team may give instructions about fasting, stopping or adjusting certain medications, and arranging transportation home. It is also important to ask the surgeon when to stop smoking, when to pause blood thinners if prescribed, and what activities should be avoided before the procedure.
How it is performed
Microdiscectomy is usually performed under general anesthesia. The surgeon makes a small incision in the lower back and uses special instruments, often with a microscope or magnifying tool, to see the affected area more clearly.
A small amount of bone or ligament may be moved or removed to reach the compressed nerve. The surgeon then gently moves the nerve aside and removes the piece of herniated disc that is pressing on it.
There are different approaches to this surgery, including conventional microdiscectomy, tubular microdiscectomy, and endoscopic techniques. These approaches may use different tools and incision sizes, but the main goal is the same: to remove the disc material causing nerve compression.
Recovery after surgery
Recovery after microdiscectomy varies from person to person. Some people notice leg pain relief soon after surgery, while numbness, tingling, or weakness may take longer to improve because nerves need time to heal.
Most people are encouraged to walk soon after surgery, but heavy lifting, bending, twisting, and high-impact activity are usually limited during early recovery. The surgeon may recommend physical therapy to improve movement, strengthen the back and core muscles, and support a safe return to normal activity.
Return to work depends on the type of job, symptoms, and the surgeon’s instructions. People with desk jobs may return sooner than people with physically demanding jobs that involve lifting, driving, or repeated bending.
Possible risks and complications
Like any surgery, microdiscectomy has possible risks. These can include bleeding, infection, blood clots, nerve injury, dural tear, continued pain, recurrent disc herniation, or the need for another surgery.
A dural tear happens when the thin covering around the spinal nerves is opened during surgery. This can sometimes lead to leakage of spinal fluid and may require special care during or after the procedure.
Some factors may increase the risk of complications or slower recovery, such as smoking, obesity, diabetes, or previous spine surgery. Following preoperative and postoperative instructions can help reduce risk and support healing.