Discectomy: A Common Surgical Treatment for Lumbar Herniated Discs

Discectomy is one of the most commonly used surgical treatments for lumbar herniated discs. Over time, the outer surface of the intervertebral disc weakens due to aging or injury, leading to tears. The soft, flexible inner part of the disc deteriorates, moves out of place, and protrudes through these tears, resulting in a herniated disc.

The herniated disc material can compress or damage the nerve root, causing pain, weakness, and numbness in one or both legs. Microdiscectomy is performed to remove the herniated disc fragments, relieve pressure on the nerve root, and alleviate pain. The procedure involves a small (2 cm) skin incision, with minimal muscle disruption and less bone removal. As microscopes and micro-surgical instruments are used, nerve damage risk is significantly reduced, allowing faster recovery and return to work.

Who Needs Discectomy?

Not all patients with herniated discs require surgery. Many individuals experience relief through rest, physical therapy, pain-relief medications, anti-inflammatory drugs, epidural injections, or neural therapy.

However, if lower back or leg pain does not respond to these treatments for 4–6 weeks or longer, doctors may request diagnostic imaging tests such as X-rays, MRI, or CT scans to pinpoint the cause of the pain. If a herniated disc is confirmed, microdiscectomy may be recommended. Microdiscectomy remains the gold standard for surgical treatment of herniated discs.

Microdiscectomy Procedure

Microdiscectomy is usually performed under general anesthesia and requires an overnight hospital stay. The procedure takes place while the patient lies face down or in a knee-elbow position.

The surgeon makes a small (2 cm) incision on the skin above the affected spinal area. The muscle tissue is gently separated, and the surrounding bone and ligament tissue are cleaned to reach the damaged disc. Using a surgical microscope, the herniated disc material is carefully removed. After the procedure, the incision is closed with aesthetic sutures, and the patient is transferred to the recovery room.

Post-Surgery Recovery and Restrictions

Patients may experience pain around the incision site after surgery, but complete relief from pain may take time. Doctors provide pain management treatments to ease discomfort during recovery.

Patients are usually encouraged to start walking within 6–8 hours after surgery. Before discharge, doctors offer guidance on daily activities, including climbing stairs, sitting, getting in and out of a car, and moving from bed.

During the first four weeks after surgery, restrictions typically include:

• Avoiding prolonged sitting,

• Not lifting heavy objects,

• Minimizing excessive bending or stretching,

• Avoiding driving until clearance from the doctor.

Walking is the first physical activity recommended, as it helps prevent tissue adhesions and maintains spinal mobility. Within a few weeks, patients may be allowed to cycle or swim. Proper physical therapy can maximize recovery.

Patients with light physical jobs can typically return to work within 2–4 weeks, while those in physically demanding occupations may need 6–8 weeks before resuming full duties.

Possible Risks and Complications

Although microdiscectomy is generally successful, some risks include:

• Bleeding,

• Infection,

• Cerebrospinal fluid leakage,

• Damage to nearby arteries and veins,

• Nerve root injury.

Additionally, there is a possibility of recurrent disc herniation at the same site after surgery. Re-herniation occurs in approximately 5–10% of cases.

If you experience persistent back or leg pain, you should discuss all available treatment options with your doctor before making a decision.