Minimally Invasive/Less Invasive Microdiscectomy

Herniated disks in the lumbar spine typically present with the sudden onset of back and leg pain in a myodermatomal distribution. Symptoms may include radicular pain, paresthesias, and in extreme cases weakness or foot drop. Typically patients are treated conservatively for 6-8 weeks with a combination of steroids, nonsteroidal anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest. In the absence of symptom improvement, surgical intervention typically with a microdisectomy is recommended to patients who are refractory to at least 6 weeks of nonoperative treatment. Earlier intervention may be considered in patients with severe or progressive neurological deficits. This paper reviews the preoperative and postoperative considerations, as well as the surgical technique, for a minimally invasive/less invasive microdisectomy.