Large herniation of L4-5 disc


A microdiscectomy is typically done for an acute or chronic disc protrusion or herniation which causes significant impingment / compression to a spinal nerve root (see images).

Clinical presentation often relates to radicular (nerve) pain in the distribution of the impinged nerve (e.g.  L5 supplies the top of the foot and big toe). Further symptoms can be pins & needles, numbness (sensory) or even weakness or muscle wasting (motor). In rare cases loss of bladder and bowel function (incontinence) can represent an surgical emergency  (immediate surgery is required).

Microdiscectomy is usually a straight forward procedure which takes about 45 to 60 minutes surgical time and requires general anaestetic. Intraoperative X-ray is used to find the correct level and the use of an operative microscope allow for a small incision (3-4cm), minimal blood loss and good visualisation of important structures (i.e. nerve). With specialised instruments parts of the protruded disc are removed and the impinged nerve decompressed.

Postopertively most patients would be allowed to mobilise after about 24 hours. A hospital stay between 2 and 4 days is typical.