Our Summary

Lumbar disc herniations (LDH), a kind of spinal degeneration, are quite common, especially in people over 35 years old. If not resolved through non-surgical means, surgery may be necessary. Treatment techniques have evolved over time, moving from more invasive approaches to less invasive ones. Micro-lumbar discectomy (MLD) is a less-invasive surgical technique that was first used in the 1970s. It uses an operating microscope to help surgeons clearly see what they are doing while making a smaller incision and causing less damage to the patient. This results in less pain, quicker recovery, and shorter hospital stays for patients. Today, MLD is considered the best approach to remove most lumbar disc herniations and can often be completed as an outpatient procedure. The major advantage of MLD over traditional surgery is that it causes less trauma to the muscles and reduces the risk of scar tissue forming after surgery.

FAQs

  1. What is a micro-lumbar discectomy (MLD) and when was it first used?
  2. What are the advantages of MLD over traditional surgery for lumbar disc herniations?
  3. Can a micro-lumbar discectomy be performed as an outpatient procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about microdiscectomy is to follow their post-operative care instructions carefully. This may include avoiding heavy lifting, bending, or twisting for a certain period of time, as well as gradually increasing activity levels as advised by the doctor or physical therapist. It is important for patients to follow these guidelines to ensure proper healing and minimize the risk of complications. Additionally, attending follow-up appointments with the surgeon is crucial for monitoring progress and addressing any concerns that may arise during the recovery process.

Suitable For

Patients who are typically recommended for microdiscectomy include those who have:

  • Severe pain in the lower back, buttocks, or legs that has not improved with conservative treatments such as physical therapy, medication, or injections
  • Numbness or weakness in the legs or feet
  • Difficulty walking or standing for extended periods of time
  • Bladder or bowel dysfunction
  • A lumbar disc herniation that is pressing on a nerve and causing symptoms

It is important for patients to consult with a spine specialist to determine if microdiscectomy is the best treatment option for their specific condition. They will need to undergo a thorough evaluation, including imaging studies such as MRI or CT scans, to confirm the diagnosis and assess the extent of the disc herniation. If surgery is recommended, the patient will need to be in good overall health and have realistic expectations about the potential outcomes of the procedure.

Timeline

Before microdiscectomy:

  1. Patient experiences symptoms of a lumbar disc herniation, such as lower back pain, leg pain, numbness, or weakness.
  2. Patient undergoes diagnostic tests, such as MRI or CT scan, to confirm the diagnosis.
  3. Patient may undergo conservative treatments, such as physical therapy, medication, or epidural injections, to relieve symptoms.
  4. If conservative treatments are ineffective, the patient and their healthcare provider may decide that surgery is necessary.
  5. Patient undergoes pre-operative evaluations and preparations for the microdiscectomy procedure.

After microdiscectomy:

  1. Patient undergoes microdiscectomy surgery, which typically takes 1-2 hours to complete.
  2. Patient may stay in the hospital for a day or two for observation, or the surgery may be done as an outpatient procedure.
  3. Patient may experience some pain and discomfort after surgery, but this typically improves over time.
  4. Patient is encouraged to gradually increase their activity level and participate in physical therapy to aid in recovery.
  5. Patient may experience improvements in their symptoms, such as reduced pain and improved mobility, in the weeks and months following surgery.
  6. Patient follows up with their healthcare provider for post-operative care and monitoring to ensure proper healing and recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about microdiscectomy include:

  1. What are the potential risks and complications associated with microdiscectomy surgery?
  2. How long is the recovery period following a microdiscectomy procedure?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What kind of pain or discomfort can I expect after the surgery, and how will it be managed?
  5. How successful is microdiscectomy in relieving symptoms and improving mobility?
  6. Are there any restrictions or limitations I should be aware of after the surgery?
  7. What is the likelihood of needing additional surgery in the future after undergoing microdiscectomy?
  8. How long will I need to stay in the hospital after the surgery?
  9. Are there any alternative treatment options to consider before proceeding with microdiscectomy?
  10. What is the long-term outlook for my condition after undergoing microdiscectomy surgery?

Reference

Authors: Dowling TJ, Munakomi S, Dowling TJ. Journal: 2023 Aug 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32310444