Microdiscectomie

Microdiscectomie, also spelled microdiscectomie in French, is a minimally invasive surgical procedure used to relieve nerve root compression caused by a herniated intervertebral disc. The operation removes only the portion of the disc that is pressing on a spinal nerve, typically in the lumbar region, to reduce radicular pain such as sciatica while preserving surrounding disc and tissue as much as possible.

Indications for microdiscectomie include persistent leg pain or weakness due to a confirmed herniated disc that has not improved with conservative treatment over several weeks to months, or the presence of progressive neurological deficits. It is not generally used for axial back pain without nerve compression or for multilevel disease where symptoms are not clearly related to a single herniation.

During the procedure, performed under general or spinal anesthesia, the surgeon makes a small incision and uses a microscope or endoscope to visualize the affected nerve root. Small amounts of bone or ligament may be removed to access the herniation, which is then excised to decompress the nerve. The goal is rapid relief of radicular symptoms with minimal tissue disruption compared with open discectomy.

Outcomes are typically favorable for relief of leg pain and functional improvement, with many patients returning to normal activities within weeks. Long-term results are comparable to open discectomy. Potential risks include dural tear with cerebrospinal fluid leak, infection, nerve injury, recurrent herniation, bleeding, and persistent pain. Recovery usually involves a brief hospital stay or same-day discharge, with gradual return to activities and guidance on lifting and exercise. Alternatives include physical therapy, epidural injections, or open or endoscopic discectomy.