Discectomy Procedures

Lumbar Microdiscectomy

Precise Removal of Herniated Lumbar Disc Material

A lumbar microdiscectomy is a minimally invasive procedure performed to relieve nerve compression caused by a herniated disc in the lower back. This is one of the most common and successful surgeries for patients with sciatica or leg pain from lumbar radiculopathy. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS specializes in lumbar microdiscectomy using advanced minimally invasive techniques. Our approach combines tiny incisions, microscopes, and precision tools to remove only the herniated fragment, preserving stability while delivering long-lasting relief.

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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.

What Is a Lumbar Microdiscectomy?

  • In simple terms: We remove the portion of the lumbar disc that is pressing on a nerve, through a tiny incision in your lower back.

  • Scientifically: Lumbar microdiscectomy involves MIS tubular access with microscope visualization, laminotomy and flavectomy, and excision of herniated nucleus pulposus fragments compressing lumbar nerve roots.


Conditions Treated

  • Lumbar herniated discs

  • Sciatica (leg pain from compressed sciatic nerve roots)

  • Radiculopathy (leg numbness, tingling, or weakness)

  • Failed conservative care – PT, medications, or injections without improvement

  • Progressive neurological deficits (weakness, foot drop)


The Lumbar Microdiscectomy Procedure: Step by Step

Plain-English Overview

  1. Anesthesia & positioning: You’re asleep under general anesthesia, lying face down.

  2. Tiny incision: 1–2 cm incision made over the lower back.

  3. Muscle-sparing access: Tubular retractor spreads muscles apart rather than cutting them.

  4. Microscope-assisted view: A microscope provides lighting and magnification.

  5. Bone window: A small laminotomy gives access to the nerve and disc.

  6. Disc fragment removal: Only the herniated portion is removed; the rest of the disc is left intact.

  7. Closure: Incision is closed with sutures or glue; patients often walk the same day.

Surgeon-Level Detail

  • Docking: Fluoroscopy confirms correct level; tubular retractor docked.

  • Laminotomy/Flavectomy: Partial lamina removal and ligamentum flavum excision to expose dura and nerve root.

  • Nerve mobilization: Traversing root gently retracted with nerve hooks.

  • Discectomy: Herniated nucleus pulposus fragments removed with pituitaries; annular tear inspected.

  • Inspection: Confirm root free and pulsatile.

  • Closure: Hemostasis, irrigation, layered closure; no drains required.


Benefits

  • Outpatient surgery in most cases

  • Immediate relief of leg pain in the majority of patients

  • Very small incision with minimal scarring

  • Preserves spinal stability

  • Quick recovery compared to open surgery


Risks & Limitations

  • Recurrent disc herniation (5–10%)

  • Infection, bleeding, dural tear/CSF leak

  • Nerve irritation or residual numbness

  • Less effective for isolated back pain without leg symptoms


Recovery Timeline

  • Day 0: Walking within hours; home same day or next morning

  • Weeks 1–2: Light activity; no lifting, bending, or twisting

  • Weeks 2–6: Desk work often possible; structured walking encouraged

  • 6–12 weeks: Physical therapy begins; gradual return to full activity

  • 3–6 months: Nerve healing continues; strength and mobility improve


Why Choose Desert Spine and Pain?

  • Neurosurgeon-led care – Dr. Greenwald is a nationally recognized expert in MIS lumbar discectomy

  • Evidence-based approach – Surgery only when conservative measures fail

  • Minimally invasive focus – Smaller incision, less pain, faster recovery

  • Patient-first philosophy – Clear education, step-by-step guidance, and compassionate support


Frequently Asked Questions

How is lumbar microdiscectomy different from standard discectomy?

Lumbar microdiscectomy uses a smaller incision, microscope assistance, and muscle-sparing techniques compared to standard open discectomy.

Will it fix my back pain?

It’s best for leg pain and nerve symptoms. Back pain may improve, but results are less predictable.

When can I return to work?

Desk jobs: often within 2–4 weeks. Physical jobs: 6–12 weeks depending on recovery.

Can the disc herniate again?

Yes, recurrence happens in up to 1 in 10 patients. Fusion may be considered if re-herniation occurs multiple times.

How does Desert Spine and Pain perform lumbar microdiscectomy differently?

We use the most advanced minimally invasive techniques, with neurosurgical precision and a focus on fast, safe recovery.


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Phoenix, AZ, USA

Dr. David L. Greenwald, MD

Neuro-Spine Surgeon

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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.

Dr. David L. Greenwald, M.D., F.A.C.S.

Neurosurgeon | Spine Surgeon | Regenerative Medicine

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