Microscopic lumbar discectomy refers to using the operating microscope for visualization while performing surgery. Lumbar refers to the five lowest vertebrae in the spine. Discectomy is the removal of herniated parts of the disc, which are compressing the nerves.
Patients with disc herniations of the lumbar spine are candidates for this procedure. Herniations can cause buttock and leg pain, numbness, and tingling. The procedure is done through a one-inch incision, tunneling down with the microscope to shave a little bone, remove a small section of ligament, then trim the fragments of disc that are compressing the nerves, allowing optimal return of function. Only loose fragements of disc are removed, leaving the majority of the disc intact. The procedure is usually done as an outpatient.
Case study:
Below is the MRI of a 30 year-old female with severe right leg pain due to a right L5-S1 herniated disk. She failed 8 weeks of conservative care, including physical therapy, anti-inflammatory agents, and epidural steroids. She underwent outpatient microscopic lumbar discectomy, and had complete relief of her leg pain immediately. She has returned to high level sports.
Resolution of leg pain is expected in over 95% of patients with microscopic lumbar discectomy, with return to all normal activities in the vast majority of cases.
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