Minimally Invasive Lumbar Discectomy
What is a lumbar discectomy?
Lumbar discectomy is a type of surgery to fix a disc in the lower back. This surgery
uses smaller cuts (incisions) than an open lumbar discectomy.
Your backbone, or spinal column, is made up of a chain of bones called the vertebrae.
Your spinal cord runs through the spinal column. The bones help protect the cord from
injury. Discs sit between each vertebra to provide cushioning and support. Large nerves
called nerve roots lead from the spinal cord through small holes in the bones called
foramen. These nerve roots send and receive signals to and from the body. The signals
are sent to and from your brain through the spinal cord.
Sometimes the outer wall of one of these discs may dry out and weaken with age or
injury. When this happens, the soft, inner part of the disc bulges out. This is called
a herniated or bulging disc. This bulging disc can press on the spinal cord and cause
symptoms such as pain, tingling, or weakness in a nearby part of the body.
During a minimally invasive lumbar discectomy, an orthopedic surgeon takes out part
of the damaged disc. This helps ease the pressure on the spinal cord. Your surgeon
can use different methods to do this. With one method, your surgeon inserts a small
tube through the skin on your back, between the vertebrae and into the space with
the herniated disc. He or she then inserts tiny tools through the tube to remove a
part of the disc. Or a laser may be used to remove part of the disc. Unlike an open
lumbar discectomy, the surgeon makes only a very small skin incision and does not
remove any bone or muscle.
Why might I need a lumbar discectomy?
You may need this surgery if you have a herniated disc in your lower back that is
causing symptoms. The symptoms may include weakness, pain, or tingling in the back
area and in one of your legs.
Lumbar discectomy can’t be used to treat all cases of back pain. And not everyone
with a herniated disc needs a lumbar discectomy. Your healthcare provider might advise
the surgery if you’ve tried other treatments but still have severe symptoms. Other
treatments to try first include physical therapy and anti-inflammatory medicines.
Talk with your provider about the risks and benefits of minimally invasive surgery
compared to open surgery. Minimally invasive surgery may lead to less pain and faster
recovery. But not all surgery centers can use this method.
What are the risks of a lumbar discectomy?
Every surgery has risks. Risks for this surgery include:
- Excess bleeding
- Blood clots
- Injury to nearby nerves
- Reaction to anesthetic agents
- Only short-term (temporary) relief and need for another surgery
Your risks may vary depending on your age and your general health. Talk with your
provider about the risks that most apply to you.
How do I get ready for a lumbar discectomy?
Ask your healthcare provider how you should plan to prepare for your procedure. Ask
if you should stop taking any medicines ahead of time, like blood thinners. Do not
eat or drink after midnight the night before your procedure.
Your provider may order other imaging tests of your spine, such as an MRI.
What happens during a lumbar discectomy?
There are several options for the surgery. Your surgeon can help explain the details
of your procedure. It may take about 1 hour. Here is an example of what you might
- You will receive a local anesthetic so that you won’t feel any pain or discomfort
during the procedure. And you will still be awake. Or you may have general anesthesia
and sleep through the procedure.
- A healthcare provider will carefully watch your vital signs during the procedure.
This includes things like your heart rate and blood pressure.
- Your surgeon will make a small incision on your back, at the level of the affected
- During the procedure, your surgeon will use a special type of X-ray to make sure of
the correct location.
- Your surgeon will first insert a wire into the intervertebral space. Your surgeon
will push a slightly larger tube over this wire. Then your surgeon will push a second,
larger tube over that one. He or she may even push a third tube over the second one.
This will gently push apart the tissue down to the vertebra. Finally, your surgeon
will remove all except the largest tube.
- Your surgeon will put special small tools through this tube, including a camera and
- Your surgeon will remove the herniated part of the disc using small tools. He or she
will also do any other needed repairs.
- The tools and tube are removed.
- A small bandage is placed to close your wound.
What happens after a lumbar discectomy?
The surgery is usually an outpatient procedure. This means you can go home the same
day. You will probably need to stay for a couple of hours after the procedure. Make
sure you have someone who can drive you home.
Your healthcare provider will give you instructions about how you can use your back.
You might need to limit lifting or bending. Your provider might have you wear a back
brace for a limited time after the procedure. Most people can go back to work within
a week or so. You may need physical therapy after surgery to help strengthen your
You may see some fluid draining from your small incision. This is normal. Tell your
provider right away if there is a large amount of drainage from the incision site.
Also call your provider if you develop a fever or if you have a lot of pain in the
Sometimes the procedure causes slightly more pain for a while. But you can take pain
medicines to ease the pain. Usually this goes away quickly. Your pain should become
less than it was before your surgery.
Make sure to follow all your provider’s instructions and keep your follow-up appointments.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure