A minimally invasive discectomy uses a much smaller incision, generally about an inch in length. This type of surgery creates a small tunnel through the muscles in the back down to the area where the herniated disc is located. In comparison, an open discectomy involves a much larger incision and also involves stripping the muscles away from the spinal column so that the surgeon can see the area where the herniated disc is located. The actual surgical procedure, removing the fragments of the herniated disc, is very similar with both techniques.

How big is the actual incision for a minimally invasive discectomy?
The tubular retractor that is used to create a tunnel down to the spinal column where the herniated disc is located measures ¾ of an inch. The actual skin incision is a little bit longer than this, but is generally about an inch in length. This type of surgery uses a "muscle splitting" approach, so that the tubular retractor is passed through a tunnel in the muscles of the back, rather than stripping them away from the spine, as in an open discectomy.

How long will I have to stay in the hospital?
One of the main advantages of performing a lumbar discectomy is less pain after the operation. This translates into a shorter hospital stay and a quicker recovery and rehabilitation.

What are the results of minimally invasive discectomy?
This type of procedure is relatively new to spine surgery, and there are no long-term results to show conclusively that this type of surgery is better than an open discectomy. However, patients who have had this type of surgery report very high levels of satisfaction and pain relief that are equivalent or better than traditional open discectomy.

How dangerous is a minimally invasive discectomy?
While all surgery involves risk, neurosurgeons who have advanced spine training take steps to minimize those risks. My fellow surgeons and I work in a surgical field that is illuminated by a very bright fiberoptic light source and magnified by a special type of video camera that provides incredible detail of the area that is being operated on. If the procedure can not be done safely with the minimally invasive technique, then we can covert the procedure to an open discectomy.

How will I know if a minimally invasive discectomy is right for me?
As surgeons, we discuss the advantages and disadvantages of this type of surgical procedure with you. We determine if the cause of your back pain is likely to get better with or without surgery, and what type of surgery is the most reliable method for decreasing your pain and relieving the symptoms of a herniated disc.

Dr. Le is a neurosurgeon with Rebound Neurosurgical Specialists. His office is located in the Physicians Pavilion. He can be reached at 360.254.6161.

You can link to all the medical specialists who partner with Southwest on our Find a Doctor area.

Published September 2007.

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