When nonsurgical treatments have not alleviated your serious leg pain, numbness, or weakness, you can turn to a surgical approach. At Mount Sinai, our surgical goal is to remove the herniated disc material that is pressing on the nerve root and causing the pain. Our surgeons can perform a minimally invasive procedure, called microdiscectomy, which takes advantage of new tools to reduce side effects and speed recovery time.

Conditions Treated by Microdiscectomy

At the Spine Hospital at Mount Sinai, we generally use microdiscectomy to treat sciatica, which typically occurs when a herniated disc or bone spur on the spine presses on part of the nerve in the lumbar spine. Sciatica causes inflammation, lower back pain, and, most commonly, leg pain.

You should consider microdiscectomy if any of these are true:

• You have extreme leg pain, numbness, or weakness that inhibits regular activity.
• You’ve tried nonsurgical approaches for at least four weeks – and nothing has worked.
• One of our surgeons does a physical exam and believes that your pain or weakness would probably get better after surgery.
• You have cauda equina syndrome, a rare disorder that is usually an emergency and requires surgery to prevent permanent damage.

Advanced Technology

When Mount Sinai surgeons perform a microdiscectomy, we use a special microscope to view the disc and nerves. This greater precision allows us to make a smaller incision, which reduces the risk of damage to nearby parts of the spine.

During the procedure, the surgeon makes a small incision in the back, just above the problem area, and moves the muscles to see the vertebrae. We do the procedure through a tubular retractor, positioned on the bone surface and use a nerve retractor to move the nerve away from the herniated disc. The surgeon then removes the herniated part of the disc, allowing the nerve to move back to its normal position. Now that nothing is pressing on the nerve, the pain is greatly alleviated.

After Surgery

Most Mount Sinai microdiscectomy patients leave the hospital the same day. You may not be comfortable sitting at first, but that will improve with time. We recommend walking as much as you can, to help lower the risk of scar tissue. Most people can return to work soon after the procedure.

• If you work in an office, you can usually go back to work at two to four weeks after surgery.
• If your job involves physical labor, you may be able to return to work within four to eight weeks after the procedure.