The procedure can be performed as a day stay surgery, but most patients stay in hospital for 1-2 nights. General anesthesia is utilized and the surgery is performed through an incision of 2-4 cm. Much emphasis is placed on performing the surgery through tiny incisions. Usually a small window is made on one side of a spinous process, at the junction of the lamina and facet joint, through the removal of some bone and ligament to allow visualization of the involved root. Using a high speed drill and microinstruments, once the nerve root affected is identified, the whole out of which the nerve passes is enlarged.
The nerve root is then gently elevated and if there is a disk bulge this is palpated. If identified, the disk bulge is incised and typically a tiny piece of disk is removed. The whole disk is not removed. The operation is then complete and after placing cortisone over the nerve root, closure is effected, typically, with dissolving sutures for skin. Typically this takes 1-2 hours to perform.