Microdiscectomy
Microdiscectomy removes herniated disc fragments pressing on spinal nerves, relieving leg pain and numbness from sciatica. Before surgery, Dr. Greenberg evaluates whether conservative treatments like physical therapy, anti-inflammatory medications, and epidural injections can resolve your symptoms. When these approaches don't provide adequate relief after 6-8 weeks, microdiscectomy offers proven results with 90-95% success rates for leg pain relief. This time-tested procedure uses microscopic visualization through a small incision, allowing same-day or overnight discharge. Care is available in Fort Wayne, Indiana.
Why Greenberg Spine
Dr. Marc Greenberg's fellowship training at Mayo Clinic, Johns Hopkins, and Brown University, combined with our focus on robotics, endoscopy, and motion-preserving philosophy, ensures you receive the most advanced outpatient spine care available.
Microdiscectomy vs Other Approaches
| Factor | Microdiscectomy | Endoscopic | Open Surgery |
|---|---|---|---|
| Incision Size | 1-2 inches | Dime-sized | 3-4 inches |
| Muscle Damage | Minimal | Minimal | Moderate |
| Hospital Stay | Same day/overnight | Same day | 1-2 nights |
| Return to Work | 1-2 weeks (desk) | 1 week (desk) | 3-4 weeks |
| Pain Relief | 90-95% | 85-90% | 90-95% |
| Best For | Standard herniated discs | Contained herniations | Complex cases |
Indications
- Herniated disc with severe leg pain (sciatica)
- Numbness or weakness in leg or foot
- Failed conservative treatment for 6+ weeks
- Progressive neurological symptoms
- Cauda equina syndrome (emergency)
How the Procedure Works
- Small incision (1-2 inches) over affected disc level
- Microscopic visualization for precision and safety
- Careful removal of herniated disc fragments
- Nerve decompression and mobility verification
- Preservation of healthy disc and bone structures
Benefits
- Excellent success rate (90-95%) for leg pain relief
- Small incision with minimal tissue damage
- Quick return to work (1-2 weeks for desk jobs)
- Outpatient surgery in most cases
- Preserves spinal motion and stability
Risks & Considerations
- Infection, bleeding, or anesthesia risks
- Nerve injury or dural tear
- Recurrent disc herniation (5-10%)
- Incomplete pain relief
- Scar tissue formation
Recovery Timeline
Day 0 (Surgery Day)
Outpatient procedure, home same day or overnight stay
Week 1-2
Walking encouraged, no lifting >10 lbs, return to desk work
Week 4-6
Physical therapy begins, gradual activity increase
6-8 Weeks
Return to physical work, full activities, sports clearance
Ideal Candidates
- Confirmed disc herniation on MRI
- Predominant leg pain over back pain
- Good general health for surgery
- Realistic expectations about outcomes
- Failed adequate conservative treatment
Alternatives
- Physical therapy and anti-inflammatory medications
- Epidural steroid injections
- Endoscopic discectomy
- Continued conservative management
Conservative Options
Before considering microdiscectomy, Dr. Greenberg typically recommends a comprehensive conservative approach including physical therapy, anti-inflammatory medications, activity modification, and epidural steroid injections. Surgery is only recommended when conservative treatments have been exhausted and symptoms significantly impact quality of life or neurological function.
What to Expect
- Pre-op visit: MRI review, surgical planning, and consent
- Anesthesia: General anesthesia with positioning
- Incision size: 1-2 inch incision over affected level
- Discharge plan: Same-day or overnight stay
- First follow-up: 1-2 weeks post-surgery
Frequently Asked Questions
What is the difference between microdiscectomy and endoscopic discectomy?
Microdiscectomy uses a microscope through a 1-2 inch incision, while endoscopic discectomy uses a camera through a dime-sized incision. Both effectively remove herniated disc material, but endoscopic approaches may offer faster recovery for appropriate candidates.
How long is the hospital stay after microdiscectomy?
Most patients go home the same day or stay one night. You'll walk within hours of surgery and can typically manage stairs before discharge.
Will I need physical therapy after microdiscectomy?
Physical therapy typically begins 4-6 weeks after surgery to restore core strength and flexibility. Early walking is encouraged immediately, but formal therapy helps optimize long-term outcomes.
Can a herniated disc come back after microdiscectomy?
Recurrence occurs in 5-10% of cases, usually within the first year. Maintaining good spine mechanics, core strength, and avoiding smoking reduces this risk significantly.
Is microdiscectomy covered by insurance?
Yes, microdiscectomy is typically covered by insurance when conservative treatment has failed and imaging confirms nerve compression. Pre-authorization is usually required.
Related Topics
Learn more about related conditions and treatments
Ready to End Your Sciatica?
Schedule a consultation to determine if microdiscectomy is right for you.