Microdiscectomy: Minimally invasive spine surgery to treat pinched nerve

What conditions can a microdiscectomy treat?

Microdiscectomy surgery is most often used to treat damaged, or herniated, discs of the spine that are compressing a spinal nerve and leading to pain. This can occur anywhere in the spine, but most often causes pain in the cervical (neck) or lumbar (low back) regions. The pain may appear only in the low back or neck, or it can radiate out into the legs or arms.

Discs are soft cushion-like structures that sit between each bone (vertebrae) in the spine. They act as shock absorbers and facilitate movement between the spinal bones. Each disc has a strong outer ring of fibers and a soft jellylike central portion.

Wear and tear, called osteoarthritis, causes most herniated discs. Discs also may rupture as a result of sudden force or pressure. In addition, prolonged bending or heavy lifting may contribute to herniated discs. 

How is microdiscectomy performed?

During microdiscectomy, one of our expert Denver spine surgeons makes a tiny, 1- to 1.5-inch incision in the lower back or the back of the neck to reach the damaged disc.

The neurosurgeon uses special retractors and an operating microscope to visually enlarge the surgical area, providing the surgeon a clear view with minimal or no cutting of the adjacent muscle and soft tissue. After the retractor is in place, an X-ray is used to confirm that the appropriate disc is identified.

In some cases, a small portion of the inside facet joint is removed, both to facilitate access to the nerve root and to relieve any pressure or pinching on the nerve.

The surgeon uses micro instruments to go under the nerve root and remove the fragments of disc material that have extruded out of the disc.

The muscles are moved back into place, and the incision is closed. The procedure usually takes about one to two hours.

Most patients are able to go home the day of surgery.

If needed, the surgeon may make a small opening in the bony lamina, called a laminotomy, to access the site.

Who is a candidate for microdiscectomy?

Surgery for a herniated disc generally is only considered when more conservative therapies such as steroid injections and physical therapy fail to provide adequate relief. At the Neurosurgery One Spine Center, our Denver back pain specialists also will consider interventional pain management procedures before recommending spine surgery.

Ideal candidates for microdiscectomy are those who experience:

• Back or neck pain caused by the damaged disc pressing on a nerve
• Numbness, weakness, or other symptoms in the legs or arms

In addition, at Neurosurgery One, our spine surgeons believe that surgery should be performed only when patients have a diagnosis of herniated disc that is confirmed through imaging such as MRI.

What are the benefits of microdiscectomy surgery?

Lumbar microdiscectomy is one of the most common surgeries performed to relieve back and leg pain, and it is considered highly effective, with 90-95 percent of patients experiencing pain relief. Most patients feel immediate improvement in their leg pain, some as soon as they wake up from surgery.

Patients with a partially damaged disc in the neck may prefer cervical microdiscectomy because it does not require fusion, which limits some forward motion of the head. However, because the disc is not completely removed, herniation can occur again. Additionally, the remainder of the disc can collapse and put pressure on the spinal nerves.

What are the risks of microdiscectomy surgery?

The risks associated with microdiscectomy are low, but they can include surgical site infection. However, the small incision used in microdiscectomy reduces the risk of infection.

An estimated 4 percent of microdiscectomy patients report a worsening of symptoms after surgery.

Every patient’s experience is unique. However, you may expect some or all of the following after microdiscectomy surgery:

• Most microdiscectomy patients go home the day of surgery or the following day.
• You may need help with bathing, dressing, and other activities in the first few days after surgery.
• Your spine surgeon will encourage you to gradually return to normal activities, including walking. Walking short distances at first and gradually increasing to one to two miles daily will help speed your recovery.
• You should expect to be fully recovered from surgery in four to six weeks.

Neurosurgery One utilizes a unique spine surgery recovery plan that helps patients prepare for and recover from surgery for the lower back.