Lumbar Microdiscectomy
Dr. Lauren Boden is a fellowship-trained orthopedic spine surgeon at the University of Louisville, specializing in minimally invasive spine procedures and complex spine surgery. One of the most effective surgical procedures she performs for patients suffering from severe lower back and leg pain due to a herniated disc is a lumbar microdiscectomy. This procedure offers significant pain relief and helps patients regain mobility with minimal recovery time compared to traditional spine surgeries.
A lumbar microdiscectomy is a minimally invasive spine surgery designed to relieve nerve compression caused by a herniated lumbar disc. The lumbar spine consists of five vertebrae in the lower back that are cushioned by intervertebral discs. These discs function as shock absorbers, allowing the spine to flex and move smoothly. However, when a disc herniates or ruptures, the inner gel-like material pushes through the outer layer, irritating or compressing the nearby spinal nerves.
During a lumbar microdiscectomy, Dr. Boden makes a small incision in the lower back and removes the portion of the herniated disc that is pressing on the nerve. This alleviates the associated pain, numbness, and weakness in the lower back and legs. The procedure is often performed using a high-powered surgical microscope, which enhances precision while minimizing disruption to surrounding tissues. Because it is a minimally invasive technique, patients experience less pain, a faster recovery, and reduced risk of complications compared to larger spine surgeries.
A lumbar microdiscectomy is primarily used to treat conditions where a herniated disc or disc fragment compresses a spinal nerve, leading to symptoms of lumbar radiculopathy such as:
- Leg Pain (Radicular Pain): When nerve roots in the lower back become compressed or inflamed, patients typically experience sharp pain radiating from the lower back into the lower leg. This is sometimes referred to as “sciatica” because the nerve roots commonly affected form the sciatic nerve, which runs down the back of the leg. If non-surgical treatments do not relieve persistent leg pain caused by a compressed nerve, surgery may be necessary.Lower extremity numbness or weakness: When nerve roots are compressed, pain is a common symptom. However, these nerve roots also provide sensation and motor function to the legs. Patients may experience numbness, tingling, or a burning sensation as well as weakness to specific muscles in the lower leg. If these symptoms worsen over time or do not improve with non-surgical treatments, surgery may be necessary to relief the pressure from the nerve.
- Cauda Equina Syndrome (Rare Emergency): In severe cases, a large, herniated disc can compress the nerves controlling bladder and bowel function. If this occurs, immediate surgical intervention is needed to prevent permanent nerve damage. Patients should report to the nearest emergency room if they experience bowel/bladder symptoms.
Dr. Boden typically recommends a lumbar microdiscectomy when:
- Conservative treatments have failed: Many patients try physical therapy, medications, and epidural steroid injections before considering surgery. If symptoms persist for 6-12 weeks despite these treatments, surgery may be the next step.
- Pain is severe and disabling: If the patient experiences intense, persistent leg pain that interferes with daily activities, walking, or sleep, a microdiscectomy may be necessary to restore function.
- Neurological symptoms worsen: Weakness, numbness, or loss of reflexes in the legs indicate that the nerve compression is worsening.
- Bladder or bowel dysfunction occurs: This is a medical emergency requiring immediate surgical intervention. Patients with acute changes to bowel or bladder function should report to the closest emergency room for immediate evaluation.
Ideal candidates for lumbar microdiscectomy are individuals who:
- Have a confirmed herniated disc on imaging (MRI or CT myelogram scan)
- Experience persistent leg pain, numbness, or weakness due to nerve compression
- Do not have relief with non-surgical treatments after several weeks
- Are in good overall health and do not have significant spinal instability or multiple levels of disc degeneration
Patients with mild, manageable pain or those whose symptoms improve with conservative treatment may not require surgery. Dr. Boden carefully evaluates each patient’s condition to determine if microdiscectomy is the best option.
Because lumbar microdiscectomy is minimally invasive, recovery is typically faster than with other types of spine surgery. Most patients return home the same day or within 24 hours.
Patients are instructed to avoid heavy lifting, bending, and twisting for the first six weeks after surgery to allow the soft tissues to heal and limit the chance of recurrent disc herniation. Most patients return to full activities within 6-12 weeks, but high-impact activities and heavy lifting should be approached cautiously. Full recovery takes 3-6 months. Strengthening exercises and gradual return to normal activity help ensure long-term success.
- It is minimally invasive, so recovery is easier than with larger spine surgeries.
- Lumbar microdiscectomy has a high success rate, with 80-90% of patients experiencing significant pain relief and improved function. While it is a durable solution, maintaining a healthy weight, engaging in core-strengthening exercises, and using proper body mechanics can help prevent future disc problems.
Although complications are rare, risks include:
- Infection
- Nerve injury
- Recurrence of disc herniation (5-10% of cases)
- Spinal fluid leak (dural tear)
Dr. Boden takes every precaution to minimize risks and ensure the best possible outcome for her patients.
A lumbar microdiscectomy is an effective, minimally invasive procedure for patients suffering from persistent nerve pain caused by a herniated lumbar disc. Under the expert care of Dr. Lauren Boden at the University of Louisville, patients can expect significant pain relief, quick recovery, and improved quality of life. If you are struggling with sciatica or radicular pain and conservative treatments have not provided relief, schedule a consultation with Dr. Boden to determine if a lumbar microdiscectomy is the right choice for you.
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About Our Team
- Fellowship-Trained Orthopedic Surgeons
- Assistant Professors of Orthopedic Surgery, University of Louisville
- Authors of orthopedic research and publications
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