Spinal microdiskectomy is the minimally invasive surgical removal of disk fragments from a herniated disk, usually in the lower back (lumbar area). Unlike lumbar spine surgery that requires an incision 2 to 5 inches long, microdiskectomy is performed through a very small incision (about 1 to 1 ½ inches).

Microdiskectomy is conducted in a hospital or outpatient surgical center while the patient is under local anesthesia (awake but pain-free) or general anesthesia (asleep and pain-free). A special high-powered microscope magnifies the affected disk(s) and nerves, and guides the doctor during surgery.

A tiny surgical cut is made on the patient’s back, and the surgeon moves the back muscles away from the spine. After identifying and moving the nerve root, the surgeon removes the injured disk tissue and fragments. The back muscles are then moved back into their normal position, and the wound is closed with stitches or staples.

It’s important to note that patients with low back pain are usually treated conservatively before surgery is considered. Bedrest, traction, anti-inflammatory medications, physical therapy, and exercise are often prescribed.

Spinal microdiskectomy is done to relieve nerve pain and pressure. It may be performed in patients with the following conditions:

• Herniated lumbar disk
• Leg pain or weakness (sciatica) caused by a herniated disk
• Cauda equina syndrome

Risks include the following:

• Nerve root damage
• Dural tears (tears to the tissue called the dura mater, which covers the spinal cord and spinal nerves)
• Re-herniation of the same disk

Because of the small incision, the doctor may miss some disk fragments. This could result in persistent pain.

Most patients have pain relief and improved function after surgery, and numbness and tingling gets better.

You will be encouraged to get up and walk around as soon as your anesthesia wears off. Most microdiskectomy patients are released the day of surgery.

Patients typically are able to go back to your normal activities shortly after surgery, but should avoid sitting for prolonged periods or lifting heavy objects. When lifting anything, be sure to lift with your knees (instead of bending over). This is necessary to avoid further injury

If you work in an office, you’ll most likely be able to return to work within 2 to 4 weeks. But if your job is more physically demanding, you may have to wait for up to 3 months.

Your doctor may recommend an exercise or physical therapy program to speed your recovery.

Deen HG, Fenton DS, Lamer TJ. Minimally invasive procedures for disorders of the lumbar spine. Mayo Clin Proc. 2003 Oct;78(10):1249-56. Review.

Koebbe CJ. Lumbar Microdiscectomy: A Historical Perspective and Current Technical Considerations. Neurosurg Focus 13 (2): Article 3, 2002.