Microdiscectomy is a procedure to treat a herniated disk. A surgeon cuts out a section of the spinal disk to relieve pressure on a nerve, using microscopic techniques to reduce the impact of the surgery.

This article explains microdiscectomy, including the uses, benefits, procedure, and risks. It also answers some frequently asked questions.

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Microdiscectomy is a surgery that healthcare professionals use to treat herniated disks.

It is a type of discectomy in which a surgeon cuts out a section of the spinal disk to relieve pressure on a nerve.

A microdiscectomy is less traumatic than an open discectomy because it uses a smaller incision and either an operating microscope or magnifying loupes and a headlamp.

An open discectomy is a procedure that gives a surgeon more options during a complicated surgery, but it usually requires a longer hospital stay than other methods and can involve a longer recovery.

Less invasive techniques are becoming increasingly popular and widespread.

Learn more about surgery for herniated disks.

A discectomy procedure is a last resort when conservative efforts to treat a disk herniation do not succeed. Most disk herniations heal within a few weeks, so it is better to wait before having surgery.

Sometimes, it is possible to treat a disk herniation using exercises and other nonsurgical methods. Conservative efforts for managing a disk herniation can include:

What is a herniated disk?

Disks are sections of squidgy, cartilaginous material that provide cushioning between the individual vertebrae in the spine. The spine has 25 disks, which are vital for ease of movement and structural support.

A disk herniation occurs when the material in the middle of the disk “leaks” out beyond the external disc layer. Some people may have disk herniations without realizing it. However, if the disk material presses on a spinal nerve, it can cause severe pain. This can impact a person’s quality of life.

If conservative methods of treatment are not successful, a discectomy surgery can release the pressure on the nerves by removing the disk material.

Learn more about back pain.

In addition to being physically disabling, a disk herniation can cause severe pain, and the persistence of symptoms can make a person feel hopeless, affecting their mental health.

If pain from a herniated disk reaches a point where surgery is necessary, then a microdiscectomy can provide relief.

During a microdiscectomy, a surgeon removes a section of the spinal disk to relieve pressure on the nerves through decompression. Because it involves minimally invasive techniques, a microdiscectomy has minimal impact on the bone and healthy tissues.

Preoperative assessment

A preoperative assessment usually happens a few days before the surgery. A healthcare professional will conduct an overall health check to ensure that the person is a good candidate for surgery. They may also perform blood tests.

Sometimes, an X-ray or magnetic resonance imaging (MRI) scan of the spine is necessary to provide a more recent image of the area. This is particularly the case when it has been a while since the original scan that showed the herniation.

Before surgery

Before surgery, a person should not eat or drink for 7 hours, except for water. They should consume only small sips of water for the final hour before the procedure.

Showering before the surgery reduces the chance of infection. It is also a good idea because it may be a while before the person next has an opportunity to shower.

Healthcare professionals will ask a person to remove all makeup, jewelry, and clothing before the operation. The hospital will provide an open-backed gown to wear.

During surgery

A person will receive general anesthetic, so they will be asleep during the surgery. The procedure typically takes 1–2 hours, though it can vary from one case to another.

A surgeon will then perform the following procedure:

  1. The surgeon makes a small 2- to 3-centimeter incision on a person’s back, at the level of the herniated disk.
  2. They use a lighted microscope to examine the affected disk. They may also perform another X-ray to check the location of the damage.
  3. The surgeon may remove a small section of the spinal bone (the inferior facet of the superior vertebra) to expose the nerve root.
  4. They can now remove the fragmented or herniated disk tissue to relieve pressure on the spinal nerve.
  5. The surgeon closes the incision with stitches.

After surgery

A person may experience pain immediately after waking up from surgery and once the anesthesia wears off, but pain relief is available to help with this.

A healthcare professional will regularly check a person’s blood pressure and pulse, among other observations. A wound drain will sometimes be necessary, but not always.

Before discharging a person from the hospital, a healthcare professional is likely to check that the person can use the toilet and will make sure there are no signs of a cerebrospinal fluid leak.

Usually, a doctor will perform a microdiscectomy in an outpatient setting, meaning the person does not have to stay in the hospital after surgery.

Recommendations will vary, depending on the individual and the hospital procedure.

There are different methods of closing the wound, but if a person has stitches, they will need to see a healthcare professional to have the stitches removed approximately 7 days after the procedure.

Advice on showering varies, but it is important to protect the wound from water or any possible source of infection while it is healing.

Recovery typically takes 6–8 weeks. Symptoms may fluctuate during this time as the spinal nerves recover.

A person should avoid sitting still for more than 20 minutes but should be aware that activities may feel more tiring than usual. It may take a couple of weeks before a person can return to walking as expected, particularly if they could not walk typically before the procedure.

It is often a good idea to seek physical therapy when recovering from surgery. Recommendations for when to start treatment will depend on the individual. A person can ask their doctor whether physical therapy is necessary and when to start it.

Several complications can occur as a result of a microdiscectomy.

These may be complications due to direct impact during the surgery, such as dural tears or nerve root injury, or indirect complications such as infection or recurring disk herniations.

However, despite possible risks, research indicates that a microdiscectomy is a safe procedure, with severe complications occurring rarely.

Prevention measures are mostly straightforward and are good practices regardless of a person’s prior condition.

Maintaining good posture, exercising regularly, and avoiding strain on the spine are all important in reducing the chances of the disk herniating again. A person should try to maintain back and abdominal muscles that will support the spine.

Additionally, people should avoid smoking. This is because nicotine can weaken the disk tissue, increasing the chance of a recurrence.

Learn more about exercises and tips to improve your posture.

A person should consult a doctor when the pain first appears. A doctor will likely suggest physical therapy and nonsurgical treatment methods for the first few weeks. They may require the person to undergo a scan before suggesting a steroidal injection, and they will offer surgery only if all other options fail.

Additionally, the U.K. National Health Service (NHS) suggests speaking with a doctor if a person with back pain is experiencing the following:

  • pain that does not respond to pain relievers
  • pain that is worse at night
  • swelling in the back
  • unexplained weight loss
  • fever
  • pain that persists after a month

If any of the following symptoms develop, seek immediate medical attention:

  • loss of bowel or bladder control
  • numbness around the buttocks or genitals
  • loss of sensation in one or both legs
  • any of the above symptoms occurring after a serious accident

Here are some answers to frequently asked questions about microdiscectomy surgery.

How painful is microdiscectomy surgery?

Pain levels may increase immediately after surgery because the procedure interferes with the spinal nerves, but this should ease in the following weeks.

People requiring a microdiscectomy surgery are often in so much pain beforehand that they are used to the sensation.

How long does microdiscectomy surgery last?

The procedure typically lasts 1–2 hours, though this can vary.

A herniated disk can put pressure on a spinal nerve, causing severe pain. This often resolves within a few weeks, but a person may require a discectomy surgery if it does not.

A microdiscectomy procedure is a form of discectomy in which a surgeon uses minimally invasive techniques to remove a section of spinal disk to release the pressure on the spinal nerve.