Lumbar microdiscectomy, unilateral

What is This Treatment?

Lumbar microdiscectomy is the removal of disc material causing pressure on the nerve root due to lumbar herniation under the surgical microscope with limited soft tissue trauma. The primary cause of pain radiating to the back and leg is often mechanical nerve compression; the aim of this procedure is to eliminate the compression and correct sciatic-type leg pain, numbness, and selected weakness in patients. Not all back pain requires surgery; however, in patients with nerve compression confirmed on imaging that has not improved despite medications, rest, physical therapy and injections, and with significantly reduced quality of life, microdiscectomy is one of the most effective surgical options.

Benefits

• Muscle and soft tissue damage is more limited compared to conventional open surgery since it is performed through a small 2-3 cm incision
• Provides rapid relief of leg pain in most patients; as nerve compression is eliminated, walking and daily activities become more comfortable
• Due to microscopic magnification, the nerve root, dural sac, and disc area are visualized more clearly, allowing for controlled surgery
• Hospital stay is short in appropriate candidates; most patients are mobilized on the same day and return to daily activities quickly

Treatment Process

Before surgery, symptoms, neurological examination, and lumbar MRI are evaluated together. The procedure is performed under general anesthesia. After confirming the level with imaging, a small incision is made, muscles are carefully retracted without complete cutting, and the nerve root is exposed under the microscope. The disc material compressing the nerve is removed; if necessary, additional decompression is performed in the narrow area. The goal is not to empty the entire disc but to safely remove the pathological fragment causing compression. After completion, bleeding is controlled, the incision is closed, and the patient is mobilized on the same day or the next day.

When is it used?

• Leg pain due to lumbar herniation that does not resolve within 6-12 weeks despite medication and physical therapy
• Nerve root compression consistent with MRI findings accompanied by numbness, tingling, or weakness
• Selected patients developing progressive motor weakness such as foot drop
• Urgent nerve compression conditions such as cauda equina syndrome that may affect bladder and bowel control

Recovery and planning

Most patients are mobilized a few hours after microdiscectomy. Hospital stay is typically same-day discharge or one night observation. Incision pain and mild back stiffness may occur in the first days; conversely, significant relief of leg pain is expected in the early period. For the first 2 weeks, it is important to avoid heavy lifting, avoid sudden bending and twisting movements, and gradually increase walking. Return to desk work is possible in 2-3 weeks for most patients, while return to heavier physical work is usually planned at 6-8 weeks. Recovery speed may vary depending on the duration of the hernia, degree of nerve damage, and accompanying neurological deficit.