What Is Microdiscectomy Surgery?

What to Expect When Undergoing Microdiscectomy Surgery

Microdiscectomy surgery, also known as microdecompression surgery, is a surgical procedure used to get pressure off a lumbar nerve due to a herniated disc in your low back. The goal of the procedure is to relieve pain, improve mobility, and help you restore normal function related to sitting, standing, and walking. Microdiscectomy surgery is performed by an orthopedic surgeon or neurosurgeon.

Photo of a surgeon pointing to a lumbar spine model.
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Purpose of Microdiscectomy

If you are feeling pain in your back, thigh, or lower leg, you may be experiencing sciatica. Your sciatic nerve is the biggest nerve in your body, and it travels from your lower lumbar spine to your foot. You have two sciatic nerves, one on each side of the body. Sciatica occurs when the nerve becomes pinched or irritated. One of the most common causes of nerve pinching in your lower back is from a herniated lumbar disc.

Your spinal column is comprised of several bones stacked upon one another. Between each bone is a spinal disc. There are two parts to the disc; the inner jelly-like material called the nucleus pulposes, and the outer cartilage called the annulus fibrosis. Sometimes the jelly inside the disc becomes displaced due to injury or repetitive stress to the disc. When this happens, the jelly may exit the disc and press against a spinal nerve.

Symptoms of a herniated disc may include:

  • Leg pain
  • Numbness
  • Tingling
  • Weakness in the muscles of your leg or legs
  • Tingling in your genital area and difficulty with bowel and bladder control (cauda equina syndrome, a medical emergency; get to a medical professional right away if you experience this)
  • Difficulty tolerating sitting, standing, bending, or walking due to leg pain

If you are feeling back pain and pain in your leg, you should visit your healthcare provider right away. They can perform tests such as an X-ray and magnetic resonance imaging (MRI) to diagnose the cause of your sciatica. If a herniated disc is found, you may be referred to a surgeon to assess the need for microdiscectomy to relieve pressure off your spinal nerve.

Keep in mind that many cases of sciatica due to a herniated disc do not require surgery. Microdiscectomy surgery is reserved for severe cases where nerve compression is causing significant pain or neurological compromise and weakness.

If your surgeon recommends surgery for your herniated disc, microdiscectomy is one option. Other options may include a lumbar laminectomy, open discectomy, or lumbar fusion surgery. You should discuss all your options with your surgeon before deciding if microdiscectomy is right for you.

The benefits of microdiscectomy over an open discectomy include less pain, less risk of infection, and quicker recovery time.

Risks and Contraindications

When deciding to have microdiscectomy surgery, it is important to understand who should not have surgery. Contraindications to microdiscectomy surgery may include:

  • Multiple level disc herniations causing pain
  • Osteoporosis or bone-weakening disease
  • Active infection
  • Advanced age with lumbar stenosis
  • Patients with anatomical variations that may limit the surgical view

Your surgeon should review the need for microdiscectomy and the risks associated with the procedure.

Expected benefits of microdiscectomy include:

  • Decreased or abolished leg pain
  • Improved mobility in your back or legs
  • Improved strength
  • Normal function related to sitting, standing, and walking

Risks associated with microdiscectomy may include:

  • Bleeding
  • Nerve root damage
  • Paralysis
  • Death
  • Infection
  • Failure to relieve symptoms
  • Deep vein thrombosis

You should discuss with your surgeon all expected benefits and risks associated with microdiscectomy surgery. That way you can make an informed decision about the procedure and if it is right for you.

Before the Microdiscectomy

Many people with sciatica from a herniated disc do not require surgery. Prior to microdiscetomy, you should attempt conservative treatment for your sciatica. This may include:

If you have tried and failed at conservative treatment and your surgeon recommends microdiscectomy, then you should prepare for the procedure. Your surgeon and their staff will give you information about prepping for surgery.

You will likely be told to avoid eating or drinking anything the evening prior to surgery. When you shower the morning of the surgery, some healthcare providers have you use a special anti-bacterial scrub on your body. This limits the risk of infection during surgery.

You will arrive at the hospital, and your vital signs will be measured. An intravenous line will be started, and you will be brought to the operating room. The surgeon, nurses, and anesthesiologist will be there. Your anesthesiologist will use medication to sedate you, and the surgery can then begin.

During the Surgery

Once you are sedated in the operating room, a small incision, usually 1 to 2 inches in length, will be made in your low back. Your vital signs will be monitored during the procedure. Specialized tools will be used to move muscles and tissue out of the way, and a microscope with a light will be placed into the surgical field. Then surgical tools will be used to locate and protect your spinal nerves.

Once your surgeon locates the herniated disc and compressed spinal nerve with the surgical microscope, tools will be used to carefully cut away disc material. This will relieve pressure off your lumbar nerve.

After decompression of the nerve, your muscles will be restored to their original position, the surgical tools will be removed, and your low back incision will be sutured. You will be brought to the recovery area where nurses and healthcare providers will ensure you safely regain consciousness from anesthesia.

After Microdiscectomy Surgery

After microdiscectomy, you will likely leave the surgical center or hospital later that same day. Some patients stay in the hospital overnight.

Upon returning home, you can expect to rest for a few days. Pain medication, such as opioids, will be prescribed, although most patients do not require opioid medication for more than a few days. After two or three days rest, you will be instructed to slowly increase your activity level.

During the immediate post-operative period, you should avoid bending or sitting slouched. These activities may pull on your incision, and they may cause re-herniation of the disc. Sit in supportive chairs, and avoid too much bending.

Some patients benefit from physical therapy to increase their activity level after microdiscectomy. Your therapist can assess your condition and movements, and then prescribe exercises to improve range of motion, flexibility, strength, and function. Your physical therapist may also help you attain and maintain proper posture to possible avoid re-herniation of your lumbar disc.

Most patients can expect to be moving normally about two to four weeks after surgery with complete resolution by eight weeks. Some patients may take a bit longer; be sure to talk to your surgeon about what to expect.

A Word From Verywell

Microdiscectomy surgery is used to relieve pressure from a spinal nerve due to a herniated disc. It is one surgical option to help relieve pain from sciatica. If you are experiencing leg pain, tingling, or weakness, and if you have failed conservative treatment, you may benefit from microdiscectomy to relieve your pain and get you back to your previous level of activity.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Anichini G, Landi A, Caporlingua F, et al. Lumbar endoscopic microdiscectomy: Where are we now? An updated literature review focused on clinical outcome, complications, and rate of recurrence. Biomed Res Int. 2015;2015:417801. doi:10.1155/2015/417801

  2. Lovecchio F, Premkumar A, Stepan JG, et al. Opioid consumption patterns after lumbar microdiscectomy or decompression. Spine. 2019;44(22):1599-1605. doi:10.1097/BRS.0000000000003129

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.