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Lumbar Spine Surgery

Microdiscectomy & Lumbar
Disc Decompression

Microdiscectomy is one of the most reliably effective operations in all of spine surgery — a minimally invasive procedure to remove the fragment of a herniated lumbar disc pressing on a nerve root. Most patients experience rapid relief of leg pain and go home the same day.

Overview

Understanding Microdiscectomy

The lumbar discs sit between the vertebrae of the lower back and act as shock absorbers. When the inner material of a disc (nucleus pulposus) pushes through its outer wall and contacts a nearby nerve root, it causes the characteristic shooting pain, numbness, and weakness of sciatica. Microdiscectomy addresses this directly — removing only the herniated fragment pressing on the nerve while preserving the rest of the disc and surrounding structures.

The procedure is performed through a small posterior incision using a surgical microscope, which provides magnified visualization while minimizing disruption to the back muscles. Unlike a traditional open discectomy, the microscope-assisted approach requires minimal muscle retraction, resulting in less post-operative pain and a significantly faster recovery. This is the standard technique used by our surgeons for lumbar disc herniation.

Microdiscectomy decompresses the nerve but does not fuse the spine — disc height and spinal motion are preserved. For patients with additional instability or significant disc loss, lumbar fusion may be a more appropriate option, which your surgeon will discuss if relevant to your anatomy.

Symptoms That May Indicate Microdiscectomy
  • Shooting pain from the low back into the buttock, leg, or foot (sciatica)
  • Numbness or tingling in the leg or foot
  • Leg or foot weakness
  • Pain significantly worsened by sitting, coughing, or sneezing
  • Symptoms persisting after 6–12 weeks of conservative care
Conditions Treated by Microdiscectomy
  • Lumbar disc herniation (most common)
  • Sciatica from nerve root compression
  • Recurrent disc herniation at a prior level
  • Lateral recess stenosis from a herniated disc
  • Foraminal disc herniation compressing an exiting nerve
When to seek care immediately: Sudden loss of bowel or bladder control, numbness in the groin or inner thighs (saddle anesthesia), or rapidly progressing weakness in both legs are symptoms of cauda equina syndrome — a rare but serious emergency. Go to the nearest emergency room or call 911.
Treatment Pathway

When Surgery May Be Considered

The majority of lumbar disc herniations improve over time with conservative care. Our surgeons follow a stepped approach — recommending surgery only when it is clearly the best option for your situation.

1
Activity modification & physical therapy
Avoiding positions that load the disc, combined with targeted physical therapy for core stabilization and nerve mobility, resolves the majority of lumbar disc herniation episodes within 6–12 weeks.
2
Medications
NSAIDs, short-term oral steroids, and neuropathic pain agents reduce nerve inflammation and improve comfort during the natural recovery process.
3
Epidural steroid injection
A targeted injection of anti-inflammatory medication near the compressed nerve root often provides significant relief, reducing the need for surgery in many patients and accelerating recovery when surgery is ultimately deferred.
4
Microdiscectomy
When conservative measures have not provided adequate relief after 6–12 weeks, when neurological weakness is progressing, or when quality of life is significantly impaired, microdiscectomy is highly effective. The procedure reliably decompresses the nerve with excellent and durable outcomes.

Exception: Progressive leg weakness, rapidly worsening neurological symptoms, or any sign of cauda equina syndrome warrants urgent surgical evaluation without completing the conservative care trial.

Recovery & Outcomes

What to Expect

Leg pain from nerve root decompression typically begins improving within days — and for many patients, within hours of surgery. Back soreness at the incision site is common in the first week and resolves quickly. There are no fusion hardware or fusion timelines to wait for; the spine is structurally intact and recovery is primarily soft tissue healing.

~90%
Of patients experience significant relief of leg pain after microdiscectomy
1–2 wks
Typical return to desk work and light daily activity
4–6 wks
Clearance for physical work, driving, and unrestricted activity

Numbness and weakness in the leg or foot tend to recover more gradually than pain — nerve healing can continue for weeks to months after decompression. Patients with longer-standing neurological deficits before surgery may experience a slower or incomplete recovery of strength and sensation, though pain relief is typically rapid regardless.

The information on this page is for general educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Microdiscectomy is not appropriate for every patient with a herniated disc. Our physicians evaluate each case individually based on imaging, clinical examination, and your specific health history. Please consult one of our surgeons to discuss whether this procedure is right for you.

Not Sure If Surgery Is Right for You?

Most herniated discs improve without surgery. Our surgeons take a conservative approach and will walk through your imaging, symptom history, and every available option at your consultation.

Schedule a Consultation Meet Our Surgeons
Conditions This Procedure Treats

Microdiscectomy is most commonly performed for lumbar disc herniation causing sciatica. If you've been diagnosed with one of the following, your surgeon will evaluate whether microdiscectomy is the right approach for your specific anatomy.

Patient Questions

Frequently Asked Questions

What is a microdiscectomy?
Microdiscectomy is a minimally invasive procedure to remove the portion of a herniated lumbar disc that is pressing on a spinal nerve root. Using a surgical microscope and a small incision in the back, the surgeon carefully moves the nerve aside and removes the disc fragment causing compression. It is one of the most commonly performed spine operations and has consistently high success rates for relieving leg pain caused by a herniated disc.
How is microdiscectomy different from a regular discectomy?
Traditional open discectomy requires a larger incision and significant muscle retraction to access the disc. Microdiscectomy uses a surgical microscope and specialized retractors to achieve the same nerve decompression through a much smaller incision with significantly less disruption to the surrounding muscles. The result is less post-operative pain, a shorter hospital stay, and a faster return to activity. The microscope-assisted approach is our standard technique for lumbar disc herniation.
When is microdiscectomy recommended?
Microdiscectomy is typically recommended when leg pain, numbness, or weakness from a lumbar disc herniation has not improved after 6–12 weeks of conservative care — including physical therapy, anti-inflammatory medications, and epidural steroid injections. Earlier surgery is considered when progressive neurological weakness is present or when daily function is severely impaired. Cauda equina syndrome — sudden loss of bowel or bladder control — requires emergency surgical evaluation.
What is the recovery time after microdiscectomy?
Most patients return to desk work within 1–2 weeks. Leg pain typically improves rapidly — many patients notice relief within days of surgery. Clearance for physical activity, driving, and lifting typically occurs at 4–6 weeks. Most patients are fully recovered and unrestricted within 6–8 weeks. Numbness and weakness in the leg or foot tend to recover more gradually than pain, as nerve healing continues for weeks to months after decompression.
Is microdiscectomy done as outpatient surgery?
Yes — microdiscectomy is routinely performed as an outpatient procedure or with a single overnight stay, depending on the patient's health history and the surgeon's assessment. Most patients go home the same day. The procedure is performed at SSM Oklahoma Spine Hospital, a physician-owned facility purpose-built for spine surgery.
Will the disc herniate again after microdiscectomy?
Recurrent disc herniation at the same level occurs in approximately 5–10% of cases. The risk is highest in the months immediately following surgery, during which lifting restrictions and activity guidelines are important to follow. If recurrence does occur, options include a repeat microdiscectomy or, depending on the extent of disc loss and stability, lumbar fusion. Your surgeon will discuss recurrence risk and prevention strategies specific to your anatomy.
What are the risks of microdiscectomy?
Microdiscectomy has a low overall complication rate. Potential risks include recurrent disc herniation, dural tear (leakage of spinal fluid, which is typically managed intraoperatively), nerve injury, infection, and standard surgical risks. Serious complications are uncommon. Your surgeon will review all risks relevant to your anatomy and health history during your consultation.
(405) 748-3300  ·   Fax: (405) 749-1671  ·  Monday – Friday 8:00 AM – 5:00 PM
Clinical References
AANS — Herniated Disc North American Spine Society — Microdiscectomy NIH MedlinePlus — Lumbar Disc Surgery

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