A discectomy is the surgical removal of a herniated disc from the spinal canal. A herniated disc is a part of the disc that protrudes into the spinal canal and compresses the spinal cord and the nerves surrounding the spinal cord. The symptoms caused by this compression are unique to the manifestation of a herniated disc. Surgical treatment of a herniated disc is the removal of the part of the disc that is compressing the nerve. It is called a discectomy. The traditional procedure is called an open discectomy. This means that the surgeon applies a small incision to remove the herniated disc under direct vision to relieve the nerve compression. How is a discectomy performed? A discectomy is performed under general anesthesia. The length of the procedure depends on the extent of the herniated disc, the patient’s weight and other factors, and usually takes about an hour. The patient is placed in the prone position during the procedure. To remove the herniated disc, the surgeon makes an incision in the center of your back, approximately 4-6 cm long. The paravertebral muscles are carefully peeled away and a small portion of the bone and ligaments are removed with special instruments, which is called a laminectomy. Once the bone and ligaments have been removed, the spinal nerve can be seen and protected. When a herniated disc is found, the herniated disc is removed, and sometimes it is desirable to remove more disc tissue to prevent a portion of the disc tissue from protruding in the future. After removal of the herniated disc around the nerve, the incision is sutured, dressed, and the procedure is completed. How do I recover after a discectomy? It takes several weeks for the patient to return to normal after the surgery although the pain in the leg disappears when the patient is awake. Pain around the incision is common and can be relieved by oral pain medication. The pain around the incision disappears after 3-5 days and after 1 week you can walk around on the floor wearing an apron. After surgery, patients are encouraged to perform general activities such as sitting and walking with a straight spine. Patients must avoid heavy lifting, excessive bending activities, and strenuous activities and exercises until cleared by the surgeon. What are the potential complications of discectomy? The most common complication of a discectomy is that the normal disc that was not removed may still have the opportunity to re-protrude and cause the same symptoms. This is called recurrent disc herniation. The chance of recurrence after surgery is about 5-10%. Most patients’ symptoms disappear after surgery, however, the success rate of surgery is about 85-90%. This means that there are still about 10% of patients who still have symptoms after surgery. The longer the duration of symptoms before surgery, the greater the neurological impairment and the higher the risk of incomplete recovery after surgery. Other surgical complications include cerebrospinal fluid leakage, bleeding, and infection. All of these complications can be cured, but may have a prolonged hospital stay or require additional surgery. What is endoscopic microdiscectomy? Endoscopic microdiscectomy is a new technique. The spine surgeon removes the herniated disc with specially designed instruments under a tiny incision endoscope. Although the procedure is performed endoscopically, the goal is to remove the herniated disc in the same way as open surgery. In open surgery, the herniated disc is removed under direct vision, while in endoscopic discectomy, the herniated disc is found with a camera and then removed with a specially designed instrument. The advantage is that the incision is small and does not require excessive tissue stripping. The indications for endoscopic microdiscectomy are limited, and not all patients are candidates for this procedure. The vast majority of patients will do better with traditional open surgery. The procedure that is best for your condition is the best, not the one with the smallest incision and minimally invasive procedure. This requires a conversation with your surgeon to determine the surgical option.