Microdiscectomy is a procedure that involves removing the extruded part of a herniated disc. The surgery is generally done to decrease or resolve radicular pain caused by nerve root irritation and/or compression, referred to as sciatica.
A microscope is used for lighting and magnification, making the disc easier to see. Hence the term “microdiscectomy.”
Microdiscectomy surgery is generally successful at decreasing sciatica symptoms. Although conservative treatment (exercise) ends up being just as effective in mid to long term. Microdiscectomy will reduce sciatica symptoms sooner compared to conservative treatment. Once time passes and results are compared there is no difference between having the surgery compared to not having it. Outcomes (pain and function) become the same at around three months. At one year and beyond people who have microdiscetomy surgery have no less pain compared to those who don’t have surgery.
References
Gugliotta M, da Costa BR, Dabis E, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016;6(12):e012938. Published 2016 Dec 21. doi:10.1136/bmjopen-2016-012938
Jacobs WC, van Tulder M, Arts M, et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J. 2011;20(4):513–522. doi:10.1007/s00586-010-1603-7
FAQ
A surgical procedure that removes part of a herniated disc. A microscope is used for lighting and magnification. The procedure is usually done to address sciatica symptoms.
Limit repetitive lumbar flexion, end-range lumbar flexion, prolonged lumbar flexion (30 minutes or more), and flexion with rotation for the first six weeks post-op. Train the trunk stabilizers for endurance, neuromuscular control, and strength. Maintain a neutral lumbar spine by incorporating the hip hinge movement pattern during everyday activity.
Expect decreased or eliminated sciatica/radicular leg pain. Expect a sore, stiff lower back. Microdiscectomy surgery is not a guarantee. If leg pain is still present it may decrease over several weeks or months and eventually go away. It may stay the same. Expect to work on trunk stabilization training to reduce the likelihood of future lower back problems.
Avoid repetitive lumbar flexion, end-range lumbar flexion, prolonged lumbar flexion (30 minutes or more) and flexion with rotation for the first six weeks post-op. After six weeks gradually start to move into flexion ranges that are tolerated. Do not sit around and be sedentary. The muscles of the lower back and trunk need to be trained in order to support the spine and keep it healthy. Do not slack on the rehabilitation process. Get moving. Walking and trunk stabilization training should be the focus.
You will be up and walking the same day as the surgery. Most people return to regular activities around four to six weeks post-op. The sooner you start walking and begin a trunk stabilization training program the quicker you’ll return to regular activities without any problems.
