Microdisectomy - Atlas Orthpaedic Group

Microdiscectomy

Microdiscectomy is usually performed to treat persistent back and leg pain, numbness and weakness in the leg that arose from nerve compression caused by a herniated disc. As a minimally invasive procedure, the recovery time is generally shorter than traditional open surgery.

Medically reviewed by Dr Chua Soo Yong ,

Consultant Orthopaedic & Spine Surgeon

MBBS (S’pore), MRCS (Edinburgh), MMed (Ortho),FRCS (Ortho), FAMS (Ortho)

What Is Microdiscectomy?

A microdiscectomy, or microdecompression, is a surgical procedure to relieve pressure on a spinal nerve root. This pressure, often caused by a herniated lumbar disc, can lead to pain and sometimes neurological issues. The procedure involves the removal of the small portion of the bone over the nerve root and/or disc material from under the nerve root to give it adequate space and provide a better healing environment.

During a microdiscectomy, surgeons operate with high magnification and precision tools, allowing for a smaller incision and minimal tissue damage while maintaining high surgical accuracy. The goal is to alleviate symptoms without affecting the mechanical structure of the patient's lower spine.

Who Needs a Microdiscectomy?

Microdiscectomy may be recommended when non-surgical interventions have proven insufficient to relieve symptoms. Ideal candidates for this procedure often exhibit the following symptoms or conditions:

Persistent Pain – People who experience persistent and substantial pain, especially in the lower back. Sometimes, the pain may radiate down the leg.
Muscle Weakness – In some cases, the pain may be accompanied by weakness, tingling and numbness, especially of the leg.
Herniated Disc – People who have been diagnosed with a herniated disc and is symptomatic.
Neurological Symptoms – Patients showing signs of acute neurological issues, such as loss of bowel or bladder control or 'foot drop'.

What Can Be Treated with Microdiscectomy?

Microdiscectomy is an effective treatment for several types of herniated disc disorders:

Disc Protrusion – This occurs when the disc's outermost layer remains intact, but the disc bulges out into the spinal canal, often leading to nerve compression.

Disc Extrusion – Here, the inner content of the disc breaches through the outer layer but remains within the disc, pushing into the spinal canal and potentially impinging on the nerves.

Disc Sequestration – This is a severe form of disc herniation where a piece of the disc's nucleus breaks through the outer layer and moves into the spinal canal, posing a risk to nerve structures.

Central Herniations – These occur centrally within the spinal canal and can compress the spinal cord or cauda equina, often resulting in significant pain or even neurological deficits.

Lateral Recess Herniations – This involves herniation into the lateral recess of the spinal canal, often leading to nerve root compression and corresponding symptoms on one side of the body.

Foraminal Herniations – These herniations protrude into the intervertebral foramen, the passageway through which spinal nerves exit the spinal canal, often causing nerve impingement and radiating pain.

Far Lateral Herniations – These occur outside the spinal canal's confines, in the lateral area, and can compress the nerves, leading to pain, numbness, or weakness in the area served by the affected nerve.

What are the Benefits of a Microdiscectomy?

Patients who undergo a microdiscectomy can experience many benefits, including:

Pain Relief – Most patients experience significant pain relief of the leg

Quicker Recovery – As a minimally invasive procedure, the recovery time is generally shorter

Minimal Scarring – The smaller incision results in less internal and external scarring

Preserved Spinal Motion – The surgery does not alter the mechanics of the spine

Lower Risk of Complications – Due to its minimally invasive nature, it carries a lower risk of infections and other complications

What are the Types of Microdiscectomy?

Traditional Microdiscectomy

Traditional microdiscectomy has been widely used by surgeons as a form of treatment for herniated discs. It involves making a small incision in the midline of the lower back, through which the surgeon removes a small portion of the bone and/or ligament from the spine to gain access to the herniated disc. The surgeon carefully extracts the protruding disc material, freeing the compressed nerve. The duration of the surgery usually takes approximately 1 to 2 hours to complete.

Endoscopic Discectomy

The endoscopic discectomy is a newer technique and less invasive compared to the traditional approach. In this procedure, the surgeon makes a very small incision in the back and uses an endoscope—a specialised instrument fitted with a camera and light—to visualise the surgery on a monitor and navigate with greater precision and clarity. This procedure takes about an hour to complete.

What is the Recovery Like?

Recovery time can vary greatly among patients based on individual health factors and the specific nature of the procedure. Generally, patients are encouraged to walk and engage in limited activities within the first few weeks after surgery. Most people can return to their regular activities around the 4 to 6-week mark, with full recovery taking up to a few months.