Lumbar Microdiscectomy in New York

Name: Lumbar Microdiscectomy
Published: 2026-05-11

Also known as: Microdiskectomy, Lumbar Microdiskectomy, Microscopic Discectomy, Lumbar Disc Surgery, Minimally Invasive Lumbar Discectomy

4 min read

Reviewed by Dr. Maya Chen, MD, FAAOS

Dr. Marcus Rivera

Fellowship-trained orthopedic surgeonsacross two New York City offices

More than 1,500 lumbar microdiscectomies performed, but the operating-room number is not the headline. The headline is the conservative-first protocol that runs in front of every one of them: structured rehab, image-guided injections, and a 6-to-12-week observation window before surgery is on the table. Dr. Marcus Rivera operates only when leg pain or weakness persists past that line — and when he does, the microscope-assisted approach decompresses the nerve through a 1- to 2-centimeter incision, with most patients home the same day.

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Lumbar microdiscectomy is a minimally invasive spine surgery in which a small portion of a herniated lumbar disc that is pressing on a nerve root is removed using an operating microscope or surgical loupes through a small incision in the lower back. The procedure is most often used to relieve sciatica caused by a herniated disc that has not improved with conservative care. Because the surgeon works through a 1 to 2 centimeter incision and does not need to remove significant bone, joints, ligaments, or muscle, most patients go home the same day or the next morning and experience a relatively quick return to walking and light activity.

At a Glance

Lumbar microdiscectomy is among the most commonly performed spinal surgeries in the United States and is considered the standard surgical option for most lumbar disc herniations^[1]
Reported successful outcomes for relief of leg pain (sciatica) are achieved in approximately 90 percent of cases at 6 months, declining modestly with longer-term follow-up^[2]
Randomized trials suggest microdiscectomy provides faster relief of sciatica than continued non-operative care, although outcomes between the two groups converge by approximately 1 to 2 years in many patients^[5]

Overview

During a lumbar microdiscectomy, the surgeon makes a small midline incision over the affected disc level and uses retractors to gently separate the back muscles rather than cutting through them. A small portion of the lamina (laminotomy) and ligamentum flavum is removed to expose the nerve root and the herniated disc fragment.

Using an operating microscope or magnifying loupes for enhanced visualization, the surgeon gently retracts the nerve root and removes the herniated disc fragment that is compressing it. The remaining disc space is generally not removed, which preserves spinal stability and height. The goal is to take pressure off the nerve, not to fix the disc itself.

Lumbar microdiscectomy is widely considered the standard surgical option for removing most lumbar disc herniations and is among the most commonly performed spine procedures in the United States. Reported success rates for relief of leg pain are high in the first 6 to 12 months, with a smaller proportion of patients experiencing recurrent herniation or new herniation at another level over longer follow-up.

What to Expect During Treatment

1Preoperative evaluation, including history, physical examination, and imaging such as MRI to confirm the disc herniation level matches the patient's symptoms
2General anesthesia is administered and the patient is positioned prone with the abdomen free
3The level of surgery is confirmed under fluoroscopy or with an intraoperative radiograph
4A small midline incision is made and tubular or Caspar retractors are placed to expose the lamina
5A small laminotomy and partial flavectomy are performed using an operating microscope or surgical loupes
6The nerve root is identified and gently retracted, and the compressing disc fragment is removed
7The wound is irrigated and closed in layers with absorbable sutures and skin closure
8Patients are typically observed in recovery and discharged home the same day or after an overnight stay

How does Lumbar Microdiscectomy work?

The patient is positioned prone on the operating table with the abdomen free to reduce venous pressure and bleeding in the surgical field. The level of surgery is confirmed with intraoperative fluoroscopy or radiographs.
A small midline incision, typically 1 to 2 centimeters long, is made over the affected disc level. Tubular retractors or small Caspar retractors are introduced to gently separate the paraspinal muscles rather than cutting through them.
Using an operating microscope or surgical loupes for magnification, the surgeon performs a small laminotomy to expose the lateral edge of the spinal canal. The ligamentum flavum is opened and the nerve root and dural sac are identified.
The compressed nerve root is gently retracted and the herniated disc fragment that is pressing on it is removed using small pituitary rongeurs. The disc space itself is typically not entered widely; the goal is to decompress the nerve, preserve the remaining disc, and minimize the risk of recurrent herniation.
The wound is irrigated, hemostasis is achieved, and the small layered incision is closed with absorbable sutures and skin closure. A sterile dressing is applied.

When It's Recommended

Lumbar disc herniation with leg pain (sciatica) that has not responded to at least 6 to 12 weeks of conservative care
Progressive neurologic deficit such as worsening weakness or numbness in the leg
Cauda equina syndrome with bowel or bladder dysfunction (urgent surgical indication)
Severe, intractable radicular pain interfering with sleep, work, or daily function
MRI findings of a disc herniation that correlate with the patient's symptoms and physical exam

Conditions We Treat

Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and buttocks and down each ...

Recovery & Aftercare

Most patients go home the same day or the morning after surgery, with leg pain often improved immediately or within the first few days
Walking is encouraged starting the day of surgery; short, frequent walks help reduce the risk of blood clots and stiffness
Bending, lifting more than approximately 10 pounds, and prolonged sitting are typically limited for 2 to 6 weeks depending on surgeon protocol
Return to desk work is often possible within 1 to 2 weeks; return to heavy physical work or contact sports generally takes 6 to 12 weeks
Physical therapy is commonly started 2 to 6 weeks after surgery to restore core strength, mobility, and safe lifting mechanics
Most patients experience continued gradual improvement over the first 3 months following surgery
Persistent or worsening symptoms such as fever, drainage from the incision, new weakness, loss of bowel or bladder control, or severe new pain warrant prompt medical evaluation

Alternative Treatments

Structured physical therapy focused on core strengthening, lumbar stabilization, and nerve gliding exercises
Activity modification, including avoidance of heavy lifting and prolonged sitting
Nonsteroidal anti-inflammatory medications, neuropathic pain medications, and short courses of oral steroids in selected cases
Image-guided epidural steroid injections to reduce nerve root inflammation
Continued non-operative care, particularly when imaging and symptoms do not strongly correlate
Endoscopic discectomy or other minimally invasive variations in appropriately selected cases

Related Treatments

Cortisone Injection Physical Therapy

Frequently Asked Questions

Lumbar microdiscectomy is a minimally invasive spine surgery that removes a small piece of a herniated lumbar disc pressing on a nerve root. The surgeon works through a 1 to 2 centimeter incision using an operating microscope or surgical loupes for magnification. The goal is to take pressure off the nerve and relieve leg pain (sciatica) while preserving as much of the disc as possible.

The procedure itself is performed under general anesthesia, so patients do not feel pain during surgery. Many patients notice immediate relief of leg pain after waking up. Incisional soreness is typical for the first 1 to 2 weeks and is generally managed with prescribed medications and ice. Walking on day 1 is encouraged.

Lumbar microdiscectomy is generally considered safe when performed by experienced spine surgeons and is one of the most commonly performed spine procedures in the United States. Success rates for relief of leg pain are high in well-selected patients. See the safety section above for a detailed list of potential risks.

A single-level lumbar microdiscectomy typically takes between 45 and 90 minutes. The duration varies with patient anatomy, the size and position of the herniation, and whether additional levels need to be addressed.

Most patients go home the same day or the next morning. Many return to desk work within 1 to 2 weeks and to most regular activities within 4 to 6 weeks. Heavy lifting, prolonged sitting, and contact sports are typically restricted for 6 to 12 weeks. Physical therapy often starts 2 to 6 weeks after surgery.

Contact your surgical team promptly if you develop fever, drainage from the incision, new weakness or numbness in the leg, loss of bowel or bladder control, severe new pain, calf swelling, or shortness of breath. These can be signs of infection, blood clot, or recurrent disc herniation and warrant timely evaluation.

Lumbar Microdiscectomy is commonly recommended for individuals experiencing lumbar disc herniation with leg pain (sciatica) that has not responded to at least 6 to 12 weeks of conservative care, progressive neurologic deficit such as worsening weakness or numbness in the leg, cauda equina syndrome with bowel or bladder dysfunction (urgent surgical indication), severe, intractable radicular pain interfering with sleep, work, or daily function. Schedule a consultation at Halcy Orthopedics in New York to find out if Lumbar Microdiscectomy is right for you.

Lumbar Microdiscectomy is available at our Manhattan Flagship office (401 Park Avenue South, Suite 800, New York, NY 10016); our Brooklyn Heights office (75 Henry Street, Suite 320, Brooklyn, NY 11201). Contact our office to schedule an appointment at the location most convenient for you.

Your Practitioner

Dr. Maya Chen, MD, FAAOS

Fellowship-trained orthopedic surgeon specializing in cartilage preservation and minimally-invasive joint procedures. Dr. Chen treats high-performance athletes and weekend warriors alike, with a focus on returning patients to the activities they love.

Dr. Marcus Rivera, MD

Fellowship-trained orthopedic spine surgeon focused on conservative-first care for sciatica and herniated discs. Dr. Rivera has performed more than 1,500 lumbar microdiscectomies and lectures internationally on minimally invasive spine surgery.

Dr. Priya Nair, MD

Non-operative sports medicine physician focused on regenerative orthopedic care. Dr. Nair leads the practice's PRP and ultrasound-guided injection programs, and serves as team physician for two NYC-area collegiate athletic departments.

Sources & References

This article draws from 5 sources, including peer-reviewed research, leading medical institutions.

Government & Research

Medical Institutions

Medically reviewed by Dr. Maya Chen, MD, FAAOS · Last reviewed: 2026-05-11