Spinal microdiskectomy is the minimally invasive surgical removal of disk fragments from a herniated disk, usually in the lower back (lumbar area). Unlike lumbar spine surgery that requires an incision 2 to 5 inches long, microdiskectomy is performed through a very small incision (about 1 to 1 � inches).

Microdiskectomy is conducted in a hospital or outpatient surgical center while the patient is under local anesthesia (awake but pain-free). A special high-powered microscope magnifies the affected disk(s) and nerves, and guides the doctor during surgery.

A tiny incision is made on the patients back, and the surgeon moves the back muscles away from the spine. After identifying and moving the nerve root, the surgeon removes the injured disk tissue and fragments. �The back muscles are then moved back into their normal position, and the wound is closed with stitches or staples.

Its important to note that patients with low back pain are usually treated conservatively before surgery is considered. Bedrest, traction, anti-inflammatory medications, physical therapy, and exercise are often prescribed.

Spinal microdiskectomy is done to relieve nerve pain and pressure. It may be performed in patients with the following conditions:

• Herniated lumbar disk
• Leg pain or weakness (sciatica) caused by a herniated disk
• Cauda equina syndrome

Risks� include the following:

• Nerve root damage
• Dural tears (tears to the tissue called the dura mater, which covers the spinal cord and spinal nerves)
• Re-herniation of the same disk

Because of the small incision, the doctor may miss some disk fragments. This could result in persistent pain.

The majority of patients experience pain relief and improved function after surgery.

You will be encouraged to get up and walk around as soon as your anesthesia wears off. Most microdiskectomy patients are released the day of surgery.

Patients typically are able to go back to your normal activities shortly after surgery, but should avoid sitting for prolonged periods or lifting heavy objects.

If you work in an office, youll most likely be able to return to work within 2 to 4 weeks. But if your job is more physically demanding, you may have to wait for up to 3 months.

Your doctor may recommend an exercise or physical therapy program to speed your recovery.

Beers, MH. eds. Low Back Pain. In: Merck Manual of Medical Information, 3rd Home ed. New York, NY: Simon & Schuster; 2003: 515-521.

Koebbe, Christopher J., M.D., et al. Lumbar Microdiscectomy:�A Historical Perspective and Current Technical Considerations.� Neurosurg Focus 13 (2): Article 3, 2002.