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Herniated lumbar discs can cause a variety of symptoms including back pain, sciatica and leg weakness. Symptoms are generally caused by the herniated disc pressing on a nerve root. In the majority of patients with herniated lumbar discs, we strongly favor initial conservative treatment. This usually includes antiinflammatory medications, muscle relaxants and physical therapy. In selected cases, epidural steroid injections may be advised. Only a small percent of patients with herniated lumbar discs will require surgery.

Minimally invasive lumbar microdiscectomy is reserved for patients who have failed conservative treatment and have continued pain. Patients who have weakness or other neurologic deficit may be considered for surgery earlier. Minimally invasive lumbar microdiscectomy is performed in under one hour. In comparison to prior techniques for discectomy, the incision and muscle retraction required by the minimally invasive approach is considerably smaller limiting postoperative discomfort. Patients are also able to return to normal activities on an earlier basis. In our experience, 95%of patients will have relief of their pain.

The goal of minimally invasive microdiscectomy is to remove the herniated portion of the disc and to relieve pressure on the affected nerve. A half-inch incision is performed. Using X-ray guidance, a circular retractor tube is inserted to the level of the herniated disc. The operative microscope is then used to carefully remove the herniation and free the nerve. The retractor is then removed and the wound closed using plastic surgery technique. Patients are walking within a few hours after the procedure and will typically have either complete or near complete relief of their pain immediately. Patients are generally discharged either the same or the next day and can often return to work in a few days.