A lumbar discectomy (microdiscectomy) is an operation to remove part of a herniated (slipped) disc in the lower back that is pressing on a nerve, causing leg pain (sciatica). It is the most common spinal operation and has a high success rate for relieving leg symptoms.
A small incision (2–3 cm) is made in the lower back. Using a microscope or magnifying loupes, the surgeon gently moves the nerve aside and removes the piece of disc that is compressing it. Only the fragment causing pressure is removed — not the entire disc. The operation typically takes 45–60 minutes.
Surgery is recommended when a herniated disc causes persistent or severe leg pain (sciatica) that has not improved with at least six to twelve weeks of non-operative treatment, or when there is significant weakness, numbness, or bladder/bowel symptoms requiring urgent intervention.
Physiotherapy, pain medication (including neuropathic pain medication), epidural steroid injections, activity modification, and time. The majority of disc herniations improve without surgery within six to twelve weeks. Surgery is generally offered when symptoms persist or are severe.
Standard pre-assessment. MRI scan is required to confirm the diagnosis. This is usually performed as a day-case or overnight procedure. Smoking cessation is advised.
Over 90% of patients experience significant improvement in leg pain after microdiscectomy. Back pain may also improve but is less predictable. The operation is designed primarily to relieve leg symptoms caused by nerve compression.
The disc may herniate again at the same level in approximately 5–10% of patients.
Mild low back stiffness is common initially and usually settles.
Some residual numbness or tingling may persist, particularly if the nerve was compressed for a long time.
Approximately 1 in 1000 risk of nerve damage causing weakness, numbness, or pain.
A tear in the membrane surrounding the nerves occurs in 1–3% of cases. Usually managed during surgery.
Wound or disc space infection. Approximately 1%.
Extremely rare but serious compression of the nerves controlling bladder and bowel function.
Collection of blood around the nerves. May require urgent return to surgery.
Usually performed under general anaesthesia. You are positioned face-down on a specialised operating table.
Most patients go home on the day of surgery or the next day. Walking is encouraged immediately. Avoid prolonged sitting for the first two weeks. Gentle walking and stretching exercises are beneficial. Return to desk work at two to four weeks, manual work at six to twelve weeks depending on demands. Avoid heavy lifting for the first six weeks.
Wound check at one to two weeks. Surgeon review at six weeks. Physiotherapy if needed.
There is approximately a 5–10% chance of recurrent herniation at the same level. If it recurs, a repeat discectomy is usually effective, though some patients may need a fusion for repeated recurrences.
Microdiscectomy is primarily designed to relieve leg pain. Back pain may improve but is less predictable. If your main symptom is back pain rather than leg pain, other treatments may be more appropriate.
Usually at two to four weeks, once you can sit comfortably and perform an emergency stop.
There is no strict requirement. Find a comfortable position. Sleeping on your side with a pillow between your knees is often comfortable.