A lumbar microdiscectomy is the most common operation performed on the spine and is designed to relieve sciatica caused by a disc prolapse.

Why is a lumbar microdiscectomy recommended?

This surgery is recommended when a patient has persistent sciatica caused by a lumbar disc prolapse. Persistent means that the sciatica is still present and interfering with life, despite non-operative treatments.

How is the operation performed?

The surgery is performed under general anaesthetic via a small incision in the centre of the lower back. During the operation, your surgeon will check the correct spinal level with an x-ray and retract the back muscles. Under an operating microscope a small window is made in the bone and ligament to reveal the spinal nerves and disc. The bulging part of the disc and any loose fragments in the disc space are removed. The nerve is checked to see that it is free from compression as it runs out of the spinal canal. The small wound is closed with layered sutures. The operation usually lasts about an hour.

Most of your lumbar disc remains intact after this operation. Only the small prolapsed portion, and any loose fragments found in the disc space, are removed. The normal structure of your spine is maintained and recovery from surgery is usually rapid.

What happens after surgery?

After surgery you will be prescribed pain relief for muscle soreness in the back. You will be able to mobilise either on the evening of surgery or the next day under the guidance of nursing staff and physiotherapists. Patients normally require 1-2 nights in hospital. It is recommended that you do not drive for 2 weeks after surgery and that you have 4-6 weeks off work. After that, a phased return to work may be appropriate. Prolonged sitting, lifting and twisting with the lower back are to be avoided during this recovery period.

How successful is the operation?

Patient satisfaction rates are 85-90% and we expect 90% of patents to experience good or excellent relief from leg pain

What are the risks of surgery?

There is a risk of wound infection (<5%), bleeding (<1%) or spinal fluid leak (<5%). There is a 5% risk of further disc prolapse and in a small number of patents this may occur early. There is a small risk that your leg pain persists or back pain worsens. There is a very rare risk (<1 in 1000) of nerve injury causing numbness, weakness or paralysis in the legs or problems with bladder, bowel or sexual function. There is a small risk associated with general anaesthesia (heart problems, chest complications, blood clots, infection) and these risks may increase with certain medical conditions.