What Is a Microdiscectomy?

• In simple terms: We make a tiny incision in the back, remove the piece of disc that’s pressing on a nerve, and leave the rest of the disc intact.
  
  

• Scientifically: Microdiscectomy involves laminotomy and flavectomy through a tubular retractor system, followed by removal of herniated nucleus pulposus fragments compressing the traversing/exiting nerve root. The annulus and remaining disc are preserved to maintain stability.
  
  

Conditions Treated

• Herniated disc with leg or arm pain (sciatica, radiculopathy)
  
  

• Lumbar radiculopathy (leg pain from compressed spinal nerve)
  
  

• Cervical radiculopathy (select cases, usually ACDF preferred)
  
  

• Failed conservative treatment (PT, medications, injections)
  
  

• Progressive weakness or neurological deficits from nerve compression
  
  

Pre-Operative Preparation

• Imaging: MRI (gold standard) to identify level and size of herniation; X-rays or CT for bony anatomy if needed
  
  

• Diagnostics: EMG/NCV may confirm nerve root involvement
  
  

• Medical clearance: Blood work, anesthesia evaluation, review of medications (especially blood thinners/NSAIDs)
  
  

• Prehab: Core strengthening and walking programs improve recovery
  
  

The Microdiscectomy Procedure: Step by Step

Plain-English Overview

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

2. Small incision: A 1–2 cm incision is made over the affected level.
   
   

3. Muscle-sparing access: A tubular retractor gently spreads muscle fibers apart.
   
   

4. Microscope setup: A surgical microscope provides magnification and lighting.
   
   

5. Partial bone removal: A small window (laminotomy) is made to reach the nerve.
   
   

6. Disc fragment removal: Only the piece pressing on the nerve is removed.
   
   

7. Nerve decompression: The nerve root is gently freed and confirmed to be mobile.
   
   

8. Closure: The incision is closed with sutures or glue.
   
   

Surgeon-Level Detail

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

• Laminotomy & flavectomy: Kerrison punches/drill remove a small portion of lamina and ligamentum flavum.
  
  

• Nerve visualization: Dural sac and traversing root gently mobilized with microdissectors.
  
  

• Discectomy: Herniated nucleus fragment(s) identified and removed with pituitary rongeurs; annular defect inspected.
  
  

• Confirmation: Nerve root inspected for pulsation and free mobility.
  
  

• Hemostasis & closure: Irrigation, bipolar cautery, retractor removal, layered closure.
  
  

Benefits

• Outpatient or 1-night stay
  
  

• Immediate relief of sciatica in most cases
  
  

• Tiny incision, minimal scarring
  
  

• Preserves spinal stability (only fragment removed)
  
  

• Short recovery time compared to open surgery
  
  

Risks & Limitations

• Recurrence of disc herniation (5–15% risk)
  
  

• Infection, bleeding, dural tear/CSF leak
  
  

• Nerve root irritation or residual numbness
  
  

• Rare instability if excessive bone removed
  
  

• Not a cure for back pain alone (best for nerve compression symptoms)
  
  

Recovery Timeline

• Day 0: Walking within hours; many patients go home the same day
  
  

• 1–2 weeks: Light activities, short walks daily
  
  

• 2–6 weeks: Desk work; avoid bending/lifting/twisting
  
  

• 6–12 weeks: Return to most activities with PT support
  
  

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

• Full activity: Typically cleared at 3 months (except high-impact sports, which may take longer)
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon – Dr. Greenwald is highly experienced in MIS microdiscectomy
  
  

• Conservative-first approach – Surgery only when injections, PT, and other care fail
  
  

• Precision tools – Microscopes, tubular retractors, and navigation for accuracy and safety
  
  

• Compassionate care – We take time to explain every step and guide recovery confidently
  
  

Frequently Asked Questions

How do I know if I need a microdiscectomy?

If you have persistent leg or arm pain from a herniated disc that hasn’t improved with conservative care—or if you have progressive weakness—you may be a candidate.

Is recovery painful?

Most patients report immediate relief of leg pain, with manageable incision soreness that improves quickly.

Will the disc re-herniate?

It can in 5–15% of cases. If it does, revision surgery may be needed, or fusion if instability develops.

How soon can I work after surgery?

Desk jobs: 2–4 weeks. Physical jobs: 6–12 weeks depending on activity.

How does Desert Spine and Pain perform microdiscectomy differently?

We use the least invasive approach possible, with Dr. Greenwald’s neurosurgical precision, advanced tools, and a focus on faster recovery.