A widely performed surgery, microdiscectomy is considered to have relatively high rates of success, especially in relieving patients’ leg pain (sciatica). Patients are usually able to return to a normal level of activity fairly quickly.
After a microdiscectomy procedure, an exercise program is recommended to prevent disc herniation from reoccurring. See Rehabilitation After Spine Surgery
Microdiscectomy Success Rates
The success rate for microdiscectomy spine surgery is generally high, with one extensive medical study showing good or excellent results overall for 84% of people who have the procedure.1
See Lumbar Discectomy Outpatient Spine Surgery
The medical literature also points to some benefits for surgery, when compared with nonsurgical treatment, though the difference lessens over time in certain cases. One large study found that people who had surgery for a lumbar herniated disc had greater improvement in symptoms for up to two years than those who did not have surgery.2
See Postoperative Care for Lumbar Microdiscectomy Surgery
Recurrence of a Disc Herniation
Estimates vary, but between 1% and 20% of people who have a microdiscectomy will have another disc herniation at some point.3
See What's a Herniated Disc, Pinched Nerve, Bulging Disc...?
An additional disc herniation may occur directly after back surgery or many years later, although they are most common in the first three months after surgery. If the disc does herniate again, a revision microdiscectomy will generally be just as successful as the first operation. However, after a recurrence, the patient is at a higher risk of further recurrences.
See Lumbar Herniated Disc: What You Should Know
For patients with multiple herniated disc recurrences, a spinal fusion may be recommended to prevent further recurrences. Removing the entire disc and fusing the level is the most common way to assure that no further herniated discs can occur.
See Lumbar Spinal Fusion Surgery
If the posterior facet joint is not compromised and other criteria are met, an artificial disc replacement, which removes the problematic disc and replaces it with an artificial one, may be considered.
See Artificial Disc Replacement Surgery
Following microdiscectomy spine surgery, an exercise program of stretching, strengthening, and aerobic conditioning is recommended to help prevent recurrence of back pain or disc herniation.
See Stretching Exercise after Microdiscectomy Surgery
Microdiscectomy Potential Risks and Complications
As with any form of spine surgery, there are several risks and complications associated with a microdiscectomy.
A dural tear (cerebrospinal fluid leak) occurs in about 1% to 7% of microdiscectomy surgeries.4 The leak does not change the results of surgery, but the patient may be asked to lie down for one to two days after surgery to allow the leak to seal.
Other risks and complications include the following:
- Nerve root damage
- Bowel/bladder incontinence
- Bleeding
- Infection
- Possible buildup of fluid in the lungs that may lead to pneumonia
- Deep vein thrombosis, which occurs when blood clots form in the leg
- Pain that persists after the surgery
See Failed Back Surgery Syndrome (FBSS): What It Is and How to Avoid Pain after Surgery
The above complications for microdiscectomy spine surgery are not common.
References
- 1.Dohrmann GJ, Mansour N. Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Med Princ Pract. 2015;24(3):285-90.
- 2.Abraham P, Rennert RC, Martin JR, et al. The role of surgery for treatment of low back pain: insights from the randomized controlled Spine Patient Outcomes Research Trials. Surg Neurol Int. 2016;7:38.
- 3.Wera GD, Marcus RE, Ghanayem AJ, Bohlman HH. Failure within one year following a subtotal lumbar discectomy. J Bone Joint Surg Am. 2008;90:10–15. J Bone Joint Surg Am. 2008;90:10–15, as cited in Shin B-J. Risk Factors for Recurrent Lumbar Disc Herniations. Asian Spine Journal. 2014;8(2):211-215. doi:10.4184/asj.2014.8.2.211.
- 4.Kalevski S, Peev N, Haritonov D. Incidental Dural Tears in lumbar decompressive surgery: Incidence, causes, treatment, results. Asian Journal of Neurosurgery. 2010;5(1):54-59.
