Lumbar microdiscectomy is a minimally invasive operation to remove the portion of a herniated disc that is pressing on a nerve root, causing sciatica. It is the most commonly performed spinal surgery.
A small incision (2–3 cm) is made in the midline of the lower back. Using an operating microscope or magnification, a small window of bone (laminotomy) is removed to access the spinal canal. The herniated disc fragment pressing on the nerve is identified and removed. The nerve root is decompressed. The operation takes 45–90 minutes.
Microdiscectomy is recommended for sciatica (leg pain from a herniated disc) that has not improved with at least six to twelve weeks of non-operative treatment, or earlier if there is progressive neurological deficit or cauda equina syndrome (a surgical emergency).
Physiotherapy, pain medication, nerve root injection, activity modification, and time. Approximately 85% of disc herniations improve without surgery within six to twelve weeks. Surgery is for those who do not improve.
MRI confirming disc herniation correlating with symptoms. Day-case or overnight procedure.
Rapid relief of leg pain in approximately 85–95% of patients. Leg pain typically improves faster than back pain. Numbness and weakness may take longer to recover.
The disc may herniate again at the same level. Risk approximately 5-10% over a lifetime.
Leg pain improves reliably, but back pain may persist.
Some patients have temporary nerve irritation.
Tear in the membrane around the nerves, causing CSF leak. Risk approximately 1-3%. Usually repaired during surgery.
Damage to the nerve root. Risk approximately 1%.
Wound or disc space infection (discitis). Risk approximately 1-2%.
Very rare worsening of nerve compression.
Blood collection compressing nerves. Rare but requires urgent drainage.
General anaesthesia. Positioned prone (face down).
Most patients go home the same day or next morning. Walking encouraged immediately. Avoid prolonged sitting for two to four weeks. Driving at two to four weeks. Return to desk work at two to four weeks. Manual work at six to eight weeks. Core strengthening programme from four to six weeks. Full recovery six to twelve weeks.
Review at six weeks. Further follow-up only if needed.
Microdiscectomy uses magnification (microscope or loupes) and a smaller incision, causing less tissue damage and faster recovery. The outcomes are equivalent.
Yes, the risk of recurrence at the same level is approximately 5-10% over a lifetime. Maintaining core strength and good spinal health reduces this risk.
Most disc herniations improve without surgery. Surgery is recommended when pain is severe, not improving, or when there is progressive nerve damage. The timing is always a shared decision.