What is a lumbar discectomy?

A lumbar discectomy is a procedure to remove part of a damaged disc in the lower back. It is typically recommended when a lumbar disc has herniated or shifted out of place, putting pressure on nearby nerves and causing pain, numbness and even weakness in the legs.

Traditionally, a lumbar discectomy was performed as an open surgery. However, advancements in surgical techniques now allow for a more minimally invasive approach, known as microdiscectomy. This requires smaller incisions, specialized instruments, and can often be done as an outpatient procedure, so you don’t have to stay at the hospital. Minimally invasive spine surgeries, like lumbar microdiscectomy, can offer several benefits, including reduced tissue damage, faster recovery and less discomfort.

For most people, a lumbar discectomy significantly reduces leg pain, enhances mobility and improves their overall quality of life.

Parent spending time with kids after receiving the lumbar discectomy procedure

Who is a candidate for lumbar discectomy?

You may be a candidate for lumbar discectomy if you’re experiencing persistent painful symptoms due to a bulging or herniated disc in the lower back. Candidates for surgery typically have ongoing pain, numbness, tingling or weakness in their back and legs that does not improve with conservative treatments. However, not all back pain or herniated discs require this surgery.

Your doctor may recommend surgery if you have:

  • Degenerative disc disease or a herniated disc, which is compressing the nerve
  • Nonsurgical treatments such as physical therapy, medications or injections have failed to provide sustained relief
  • Trouble standing or walking due to nerve-related weakness
  • Severe pain, weakness or numbness in your leg or foot
  • Leg pain (sciatica) that's worse than back pain
  • Symptoms that progressively worsen, affecting daily activities and your quality of life
  • Severe neurologic symptoms develop, which include weakness in legs, bowel or bladder dysfunction

A thorough evaluation by a spine specialist will determine whether a lumbar discectomy is the most appropriate treatment option for you.

How to prepare for a lumbar discectomy

Proper preparation before a lumbar discectomy can enhance the outcomes of the surgery and support a smoother recovery. Your doctor will conduct a comprehensive evaluation, which may include a physical exam, blood tests and imaging such as an X-ray or MRI scan, to locate the problem area. Be sure to tell your doctor about any medications, including over-the-counter drugs, herbs or supplements you take, as you may need to stop some of them before surgery, especially blood thinners like aspirin.

If you smoke, it’s a good idea to quit at least four weeks before surgery to reduce risks. Your doctor might recommend some exercises to do before surgery to help with recovery.

After surgery, you’ll be able to walk, but you may need help with tasks like dressing, meal preparation and grocery shopping. It's a good idea to arrange for some support from family or friends and set up a comfortable recovery area at home.

The lumbar discectomy surgery

Lumbar discectomy can be performed using different techniques. Microdiscectomies are common and typically utilize a microscope or other advanced imaging tools to enhance visualization, allowing the surgeon to remove the herniated disc through small incisions while minimizing any disruption to the surrounding tissues.

In some cases, a lumbar discectomy may be performed alongside other spinal procedures. Depending on your condition and imaging results, your surgeon may perform one of the following procedures in addition to your discectomy:

  • Laminectomy: Removal of the lamina (the back part of the vertebra) to relieve pressure on the spinal canal
  • Foraminotomy: Surgery to widen the openings where spinal nerves exit the spine, reducing nerve compression
  • Spinal fusion: A procedure to surgically join two bones in your spine, increasing stability

The choice of surgical technique and any additional procedures will depend upon factors such as the severity of the disc herniation, nerve compression and overall spinal health. Your surgeon will discuss the most appropriate treatment choices based on your specific condition and goals.

What are the risks of posterior lumbar discectomy surgery?

A lumbar discectomy is generally safe, but like any surgery, there are potential risks and complications. These include:

  • Bleeding
  • Infection
  • Blood clots
  • Nerve injury
  • Complications from anesthesia
  • Spinal fluid leak
  • Recurrent disc herniation
  • Need for further surgery

Recovery

After your lumbar discectomy surgery, it’s important to protect your back while staying active. Take short walks each day and avoid sitting for long periods or lifting anything heavy or repetitive.

It's normal to feel some discomfort or mild pain around the incision site as it heals, but have a family member check for any signs of infection, like redness or drainage. Contact your healthcare provider immediately if you notice these symptoms.

Around two weeks after surgery, you'll have a follow-up with your healthcare provider to discuss your progress. By then, you should be walking with more ease and feeling better. Your doctor will check your incision, remove any stitches and encourage you to slowly increase your activity.

Within a month, you should feel close to normal, with your sciatic pain gone and walking regularly. If your job is mostly sitting, you may be able to return quickly. If it involves heavy lifting, you may need more time off.

Some people need physical therapy to help with mobility and prevent future back issues. Full recovery typically takes four to six weeks, but you may start feeling better before that. Be sure to follow your doctor’s advice to make sure your recovery stays on track.

Frequently asked questions

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