What is Microdiscectomy?
Microdiscectomy (also called microdecompression) is a minimally invasive surgical procedure to remove the herniated portion of a spinal disc that is pressing on a nerve root. Through a small 2–3 cm skin incision, a surgical microscope is used to magnify the operating field, allowing precise removal of the disc fragment while preserving as much of the normal disc as possible.
Microdiscectomy is considered the gold standard for lumbar disc herniation causing sciatica that has not responded to conservative treatment. It has a success rate of over 90–95% for leg pain relief. Most patients experience immediate relief of their leg pain upon waking from anaesthesia.
When is Microdiscectomy Recommended?
- Sciatica or leg pain not improving after 6–12 weeks of conservative treatment
- Progressive neurological weakness (foot drop, leg weakness)
- Cauda equina syndrome (bowel/bladder dysfunction) — emergency surgery
- Severe pain significantly impacting quality of life
- MRI-confirmed disc herniation matching clinical symptoms
The Procedure
Anaesthesia
General anaesthesia. Patient positioned prone. Intraoperative fluoroscopy (C-arm) confirms correct level.
Small Incision
2–3 cm incision over the affected spinal level. Tubular retractor or surgical microscope provides excellent visualisation.
Disc Removal
Small window made in the ligamentum flavum. Nerve root gently retracted. Herniated disc fragment removed precisely. Spinal canal explored.
Closure
Incision closed with absorbable sutures. No drain required. Patient mobilised 4–6 hours post-op. Discharged next day.
Recovery
Day 1
Walking with support same day or next day. Discharged with oral analgesics.
Week 1–2
Home rest. Short walks encouraged. Leg pain often resolves immediately. Back soreness normal.
Week 4–6
Return to desk work. Physiotherapy commences for core strengthening.
3 Months
Full recovery. Return to all activities. 5% risk of recurrent disc herniation long-term.