Microdiscectomy is most commonly performed in the lumbar spine to relieve the pain that shoots down the leg. The pain is most often due to pressure on a nerve root resulting from a herniated (or bulging) disc. The surgeon will make an incision in the lower back about 1.5 inches long, gently part the soft tissues, place retractors to establish a surgical field and then use a high-speed drill and microscopic visualization to remove bone so that he can access the spinal canal. At that point, a small amount of ligament will also need to be removed so the nerve can be gently retracted, allowing access to the disc fragment and the disc space. The herniated, or out of position, disc will be removed in order to decompress the nerve root. The healthy part of the disc will be left in place to continue to do its job. The retractors are removed and the skin is closed. A first-time procedure that requires only one side to be exposed typically takes about one hour. A follow-up procedure may take 1.5 to 3 hours, depending on the amount of scar tissue present from the prior surgery.

Thoracic microdiscectomy is most commonly performed to treat pain that radiates around the torso due to pressure on the thoracic nerve root, or to decompress the spinal cord itself.

Recovery varies from patient to patient. Many patients experience immediate and complete relief of leg pain; for others this is a more gradual process although a significant amount of leg pain relief can be expected. There will be incisional pain that can be readily managed by oral medications. Recovery from microdiscectomy has been significantly improved in recent years due to diminished soft tissue disruption with the traditional approach, as well as the avoidance of prolonged immobilization with the newer microendoscopic approaches.

It is important to begin to walk as soon as possible. This prevents a lot of the muscle aches and soreness that develop with inactivity. As important as beginning to walk is posture while walking, standing, and/or sitting. Gently increasing activity in the early course generally leads to a more rapid and less painful recovery. As expected, the recovery for a redo procedure can be more protracted.