A lumbar microdiscectomy is a type of spine surgery used to treat a herniated disc in the lower back (lumbar spine).

When a spinal disc herniates, the inner gel-like core (nucleus pulposus) pushes out through a tear in the outer layer (annulus fibrosus) and presses on nearby spinal nerves. This can cause:

• Severe leg pain (sciatica)

• Numbness or tingling

• Muscle weakness

• Lower back pain (less common)

Lumbar discectomy is recommended when:

• Non-surgical treatments (rest, physical therapy, medication, injections) fail after 6–8 weeks

• Pain is severe or disabling

• There’s progressive weakness or loss of bladder/bowel control (a surgical emergency)

🛠️ The Procedure

There are two main types of discectomy: open discectomy and microdiscectomy (minimally invasive).

1. Preparation

• You’ll receive general anesthesia

• You lie face-down on the operating table

• The surgical area is cleaned and sterilized

2. Incision and Access

• A small incision is made over the affected vertebrae

• Muscles are gently moved aside

• A laminotomy (small opening in the lamina bone) may be done for better access

• Microscopic loupes will be used for precision

3. Disc Removal

• The nerve root is gently retracted to reach the herniated disc

• Only the herniated portion of the disc is removed—not the entire disc

• If needed, small bone spurs or cysts pressing on nerves are also removed

4. Closure

• Muscles and soft tissue are returned to their normal position

• The incision is closed with dissolvable sutures and/or skin glue

• A sterile dressing is applied

Recovery

Hospital Stay

• Often done as day surgery or 1 overnight stay

• Minimal blood loss; small incision

Pain Relief

• Many patients experience rapid improvement in leg pain

• Numbness and weakness may take longer to resolve

Postoperative Care

• You will normally get up the same day and go to the toilet and possibly go home.

• Avoid heavy lifting, bending, or twisting for 4–6 weeks

Physical Therapy

• May be required

• Focus on core strengthening and flexibility as necessary.

Back to Activities

• Light activities: 1–2 weeks

• Desk work: ~2 weeks

• Physical labor: 6–12 weeks

• Full return to sports: 3–4 months (if no complications)

Success Rates

• 90% of patients experience good to excellent results, especially for leg pain

• Risk of recurrent herniation at the same or different level: 5–15%

What Is Lumbar Decompression Surgery For?

Lumbar decompression surgery is performed to relieve pressure on the spinal cord or nerves in the lower back (lumbar spine). This pressure is often caused by:

• Spinal stenosis (narrowing of the spinal canal)

• Herniated disc

• Degenerative disc disease

• Spondylolisthesis (slipped vertebra)

• Spinal tumors or cysts

• Bone spurs (from arthritis)

The main goal is to alleviate chronic pain, numbness, tingling, or weakness in the legs and buttocks caused by compressed nerves.

The Procedure

The exact technique can vary depending on the cause and severity, but here’s a general breakdown of the common types:

1. Preparation

• General anesthesia is administered.

• You lie face-down on the operating table.

• The area is cleaned and prepped.

2. Incision

• A small incision (5–10 cm) is made down the center of the lower back over the affected vertebrae.

• Muscles are gently moved aside to expose the spine.

3. Types of Decompression Techniques

• Laminectomy / Laminotomy:

  • Laminectomy removes part or all of the lamina, the back part of the vertebra, to create space.

  • Laminotomy removes only a small portion, often just enough to relieve pressure.

• Discectomy:

  • Removes part of a herniated disc that is pressing on nerves.

• Foraminotomy:

  • Enlarges the foramen, the passageway where nerve roots exit the spinal canal.

• Spinal Fusion(if needed):

  • May be done to stabilize the spine if there is spinal instability, often using rods, screws, or bone grafts.

4. Closure

• The surgical site is cleaned, and muscles and skin are stitched back together.

• The incision is closed with sutures or surgical glue.

Recovery

Hospital Stay

• Usually 1 to 3 days, depending on the extent of surgery.

• Some minimally invasive procedures may be done as outpatient surgeries.

Post-Operative Period

• Pain, soreness, and stiffness in the back are common but usually improve over weeks.

• Pain relief from nerve decompression is often immediate or within days.

Activity & Physical Therapy

• Gradual return to light activity in 1–2 weeks.

• Avoid bending, heavy lifting, or twisting early on.

• Physical therapy starts within a few weeks to rebuild strength and mobility.

Full Recovery

• Typically takes 6–12 weeks for most people.

• If spinal fusion was performed, recovery may take 3–6 months or longer.

Success Rates

• Good to excellent results in 90% of patients.

• Significant improvement in leg pain, walking ability, and quality of life.

• Less predictable results for back pain alone (without leg symptoms).

Lumbar spinal fusion is a surgical procedure used to stabilize the spine by permanently joining two or more vertebrae in the lower back (lumbar spine). It eliminates motion at the fused segment, which can relieve pain caused by:

Conditions Treated

• Degenerative disc disease

• Spondylolisthesis (slipped vertebra)

• Spinal instability

• Spinal stenosis (when fusion is needed with decompression)

• Recurrent disc herniation

• Fractures or trauma

• Spinal tumors or infections

The goal is to relieve pain, correct deformity, and prevent abnormal movement between vertebrae that may irritate spinal nerves.

The Procedure

1. Preparation

• General anesthesia is given

• You lie face-down on the operating table

• The surgical site is cleaned and sterilized

2. Approach Options

• Posterior Lumbar Fusion (PLF): Through the back

• Anterior Lumbar Interbody Fusion (ALIF): Through the abdomen

• Transforaminal Lumbar Interbody Fusion (TLIF): Through the side of the spine

• Lateral Lumbar Interbody Fusion (LLIF): Through the side of the body

The choice depends on the condition being treated and surgeon preference.

3. Disc Removal (if needed)

• In interbody fusion, the damaged disc is removed to create space between vertebrae.

4. Bone Graft Placement

• A bone graft (from your body or a donor) or synthetic material is placed between the vertebrae.

• This stimulates bone growth and fusion.

5. Implants

• Rods, screws, cages, or plates may be used to hold the vertebrae in place during healing.

• Implants help maintain proper spinal alignment.

6. Closure

• The incision is closed with sutures or staples

• A dressing is applied

Recovery

Hospital Stay

• Usually 2 to 5 days

• Depends on the type and number of levels fused

Postoperative Care

• Pain is expected, managed with medications

• Early walking is encouraged, often with assistance

Physical Activity

• Avoid bending, lifting, or twisting for several weeks

• Walking is the best early exercise

• Physical therapy usually starts after 6-12 weeks

Bone Fusion

• The fusion takes 6 to 9 months, sometimes longer

• Final healing may take up to 12 months

Return to Work

• Sedentary work: 4–6 weeks

• Physical work: 3–6 months (or longer)

Success Rates

• Success rate: About 70–90% depending on the condition

• Fusion normally reduces pain, especially if instability was the cause

• Fusion does not restore flexibility—the treated segment becomes rigid

Risks

• Infection

• Blood clots

• Nerve injury

• Nonunion (failed fusion) — may need revision surgery

• Adjacent segment disease (wear and tear at nearby spinal levels)

Lumbar disc replacement is a motion-preserving surgery designed to replace a damaged spinal disc in the lower back with an artificial disc. Unlike spinal fusion, which eliminates movement, disc replacement maintains flexibility at the affected level.

Conditions Treated

Primarily for degenerative disc disease (DDD) causing chronic low back pain unresponsive to:

• Physical therapy

• Anti-inflammatory medications

• Epidural steroid injections

• Activity modification

Ideal Candidates

• 18–60 years old

• One level of disc degeneration

• No significant facet joint arthritis, osteoporosis, or spinal instability

• No spinal deformities (e.g. scoliosis)

It is not recommended for patients with:

• Severe arthritis

• More than one affected discs

• Prior lumbar fusion at the same level

The Procedure

1. Preparation

• General anesthesia is given

• Patient lies on their back

• Surgical area (abdomen) is cleaned and sterilized

2. Anterior Approach

• A small incision is made in the lower abdomen

• Surgeons access the spine from the front, moving aside abdominal organs and blood vessels

• A vascular or general surgeon will normally assist

3. Disc Removal

• The damaged disc is removed completely

• The space is cleaned and measured for the artificial disc

4. Artificial Disc Insertion

• A custom-sized artificial disc (usually metal and plastic) is implanted between the vertebrae

• The device allows motion similar to a healthy disc (bending, twisting)

5. Closure

• Incision is closed with sutures or staples

• Sterile dressing is applied

Recovery

Hospital Stay

• Typically 1 to 3 days

• Walking is encouraged on the same or next day

Pain Relief

• Many patients experience back pain relief within weeks

• Leg pain is not a primary symptom addressed unless nerve compression was present

Activity Guidelines

• Avoid bending, twisting, heavy lifting for 4–6 weeks

• Walking is encouraged immediately

Physical Therapy

• Will be started after a few weeks as necessary to improve strength, flexibility, and mobility

Return to Work

• Desk work: 2–4 weeks

• Physically demanding work: 8–12 weeks

Full Recovery

• Usually within 3 months, although healing continues over 6–12 months

Success Rates

• Pain relief and function improve in 75–90% of patients

• Preserves spinal motion, unlike fusion

• Faster recovery than fusion in many cases

• Lower risk of adjacent segment disease compared to fusion

Risks and Considerations

• Infection

• Sometimes the implant does not work and the level fuses spontaneously

• Bleeding (anterior approach near major vessels)

• Nerve or vascular injury

• Implant dislocation or wear

• Need for revision or conversion to fusion (rare)

• Not widely offered everywhere (limited surgeon availability and insurance approval)