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Lumbar spineMinimally invasive surgery

Lumbar microdiscectomy

Lumbar microdiscectomy is a minimally invasive operation that removes the disc herniation fragment compressing a lumbar nerve root, most often at L4-L5 or L5-S1. Many patients reach the clinic after weeks or months of severe sciatica, leg tingling or weakness that does not improve with rest, physiotherapy, medication or injections. This guide explains realistically how the procedure is performed, what to expect during recovery and when it is indicated, so you can decide calmly and with full information.

Spine neurosurgeon in Alicante and Benidorm
More than 20 years of experience in Neurosurgery (since 2003)
Vithas Medimar Hospital Alicante and Hospital Clínica Benidorm
Lumbar microdiscectomy illustration: microsurgery with a tubular retractor removing an L5-S1 disc herniation fragment compressing the nerve root.

What is lumbar microdiscectomy?

Lumbar microdiscectomy is a surgical procedure that removes the disc herniation fragment compressing a nerve root in the lumbar spine, usually at L4-L5 or L5-S1. We work under a surgical microscope through a small incision and, in most cases, with a tubular retractor that separates the muscle without cutting it.

Compared with alternatives such as endoscopic lumbar discectomy, microdiscectomy offers a wide microscopic view and direct control of the nerve root, especially useful in extruded or migrated herniations. To assess your case, you can request an assessment with Dr. Ben Ghezala.

Symptoms and warning signs

Patients who may benefit from lumbar microdiscectomy typically report:

Sciatica: pain travelling from the lower back or buttock down the leg to the calf or foot
Tingling, numbness or burning along the affected nerve root
Leg or foot weakness (difficulty walking on heels or toes)
Positive straight-leg raise (Lasegue): leg pain reproduced by lifting the straight leg
Warning signs: sudden loss of strength, saddle anaesthesia or bowel or bladder changes, which require urgent assessment

When is lumbar microdiscectomy indicated?

Lumbar disc herniation (typically L4-L5 or L5-S1) confirmed by MRI and consistent with the symptoms
Persistent or disabling sciatica despite 6-8 weeks of conservative treatment with physiotherapy, medication or injections
Progressive motor deficit, such as foot drop or weakness of foot dorsiflexion
Pain flare-ups not controlled with well-managed medical therapy
Cauda equina syndrome or acute neurological deficit: urgent surgical indication

How is the procedure performed?

1.Preoperative preparation

It includes a clinical assessment, review of the MRI and discussion of any concerns. You will receive fasting instructions, medication adjustments (anticoagulants, antiplatelets) and tailored recommendations based on your case and comorbidities.

2.During the procedure

We operate under general anaesthesia with the patient in the prone position. We locate the affected level with fluoroscopy and make an incision of about 2-3 centimetres. A tubular retractor separates the muscle without cutting it and we work under the microscope. We remove only the necessary ligamentum flavum, identify the nerve root and extract the herniated fragment compressing it, preserving as much disc and segmental stability as possible.

3.Immediate postoperative period

After surgery, patients spend a short time in recovery before returning to their room. Mobilisation starts the same day or the following morning, with progressive sitting and walking. Hospital stay is usually 24 hours, except in selected cases that require a longer stay due to comorbidities or clinical safety.

Recovery after lumbar microdiscectomy

Sciatica relief is usually noticeable soon after surgery, sometimes on waking up. Mild low back pain at the incision improves within a few days with standard analgesia.

We return to daily life gradually: walking every day from the start and avoiding heavy lifting, sudden twists and long periods of sitting during the first weeks. Office work is usually resumed within 2-4 weeks; physical or lifting jobs between 6 and 8 weeks. Guided physiotherapy typically starts at 3-4 weeks. Fever, increasing low back pain, new weakness or bowel or bladder changes warrant prompt medical review.

Risks and possible complications

All surgery carries general risks such as infection, bleeding, thrombosis or anaesthesia-related complications.

Specific risks of lumbar microdiscectomy include nerve root injury (uncommon), cerebrospinal fluid leak from a dural tear, recurrent herniation at the same level (around 5-10 per cent in published series), residual low back pain and, exceptionally, disc space infection (spondylodiscitis). These risks are assessed individually for each patient.

Frequently asked questions

Lumbar microdiscectomy usually takes 45 to 90 minutes, depending on the size of the herniation and the anatomy. After surgery a short recovery period follows before returning to the hospital room.
Leg pain relief is usually noticeable quickly, sometimes on waking from anaesthesia. Numbness or weakness may take weeks or months to recover, depending on how long the nerve was compressed.
Office workers usually return within 2-4 weeks. For physical or lifting jobs, we plan a progressive return between 6 and 8 weeks, depending on recovery.
Yes, there is a 5-10 per cent risk of recurrence at the operated level, especially in the first months. Good ergonomics, avoiding sudden loads and keeping the core muscles fit help reduce it.
When sciatica remains disabling after 6-8 weeks of physiotherapy, medication or injections, or if weakness appears, it is usually time to consider surgery. The decision is made jointly after reviewing your imaging.
Both procedures remove the herniated fragment compressing the nerve root. Microdiscectomy uses a microscope and a tubular retractor with a wide view, very useful in migrated or extruded herniations. Endoscopic discectomy uses an even smaller incision and suits well-localised herniations. The choice depends on the type of herniation and the anatomy.

Other related treatments

Anterior lumbar interbody fusion (ALIF) illustration showing the interbody cage at L5-S1 via an anterior retroperitoneal approach.

ALIF — Anterior lumbar interbody fusion

Lumbar fusion performed through the abdomen, in collaboration with a vascular surgeon, allowing indirect decompression, restoration of disc height and lordosis and segmental stabilisation, particularly at L5-S1.

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Illustration of minimally invasive lumbar fusion showing percutaneous pedicular screws and rods placed through small skin incisions.

Minimally invasive lumbar fusion

Lumbar fusion performed through small incisions with image-guided percutaneous pedicular screws, offering less blood loss and a faster recovery than open surgery.

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Illustration of lumbar lateral recess decompression with microsurgical undercutting, freeing the nerve root while preserving the facet joint.

Lateral recess decompression

Lumbar microsurgery that frees the entrapped nerve root in the lateral recess while preserving the facet joint, relieving radicular pain and neurogenic claudication.

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Do these symptoms sound familiar?

If you recognise yourself in some of these symptoms and your pain is starting to limit your daily life, we can review your case in a personalised consultation. Dr. Ben Ghezala will assess your clinical history and imaging studies to help you decide the best treatment option for you.

Request a consultation with Dr. Ben Ghezala