Microdiscectomy

Microdiscectomy is a surgical procedure to relieve leg pain (sciatica) caused by herniation of a lumbar intervertebral disc that compresses a nerve root. It is a refined discectomy performed with an operating microscope to allow precise removal of herniated disc material while preserving surrounding tissue. Although most commonly performed in the lumbar spine, it can be used in other regions if nerve roots are affected.

Indications for microdiscectomy include persistent radicular leg pain despite conservative treatment, neurological deficits such as weakness or sensory loss, and, in some cases, cauda equina syndrome. It is typically considered after a period of nonoperative management, though progressive symptoms or severe deficits may warrant earlier intervention.

Procedure overview: under general or local anesthesia, a small incision is made near the affected level. The approach aims to spare muscle and preserve the facet joint as much as possible. The nerve root is identified and protected, and the herniated disc fragment is carefully removed under magnification to decompress the nerve. The dura is inspected for tears, which are repaired if present. The wound is closed in layers, often with minimal disruption to surrounding structures.

Recovery and outcomes: hospital stay is usually brief, with many patients going home the same day or after one night. Activity is gradually increased over several weeks. Most patients experience substantial relief of leg pain; back pain improves more variably. Return to work varies by occupation but commonly occurs within 4–8 weeks.

Risks include recurrence of herniation, nerve injury, dural tear with potential CSF leak, infection, blood clots, and residual pain. Overall success rates for relief of radicular symptoms are favorable in appropriately selected patients.