Microdiscectomy
Microdiscectomy Surgery for Herniated Disc and Sciatica in Bergen County, New Jersey.
Microdiscectomy is the most commonly performed spine surgery in the United States and one of the most effective. It is the procedure of choice for patients with a herniated lumbar disc causing significant radiating leg pain, numbness, or weakness that has not responded adequately to conservative treatment. The results are typically dramatic. Most patients experience relief from their radiating leg pain before they even leave the recovery room.
Despite being a surgical procedure, microdiscectomy is far less invasive than most patients expect. It is performed through a small incision of approximately one to one and a half inches in the lower back, using a surgical microscope that gives the surgeon a magnified, well-lit view of the affected disc and nerve root. The disc fragment pressing on the nerve is removed through this small opening, the nerve root is freed from compression, and the incision is closed. The procedure typically takes less than an hour and is performed on an outpatient basis, meaning patients go home the same day.
Rishi N. Sheth, MD performs microdiscectomy using a fully minimally invasive approach at Spine Care New Jersey. Dr. Sheth’s fellowship training in spine surgery and his extensive experience with microdiscectomy across all lumbar levels means that patients in Bergen County
have access to this procedure from a neurosurgeon whose entire training and practice is focused on the spine.
Is Microdiscectomy the Right Procedure for You?
Microdiscectomy is specifically designed to treat nerve root compression caused by a herniated lumbar disc. It is not a treatment for all types of back pain, and understanding who is an appropriate candidate is one of the most important aspects of the evaluation process at Spine Care New Jersey.
The ideal candidate for microdiscectomy is a patient whose primary complaint is radiating leg pain, called sciatica, rather than isolated back pain. When a herniated lumbar disc is pressing on a nerve root, the leg pain, numbness, and weakness it produces are the symptoms that microdiscectomy addresses most directly and most reliably. Back pain from disc degeneration without nerve compression is typically not improved by microdiscectomy.
Surgery becomes the appropriate recommendation when conservative treatment has been given a fair and adequate trial without sufficient improvement. Most spine surgeons and clinical guidelines suggest a period of six to twelve weeks of conservative care including physical therapy and epidural steroid injections before recommending surgery for a herniated disc, except in specific circumstances.
There are situations where earlier surgical intervention is warranted rather than waiting. Progressive neurological weakness in the leg or foot, particularly foot drop, suggests that the nerve is being damaged by ongoing compression and that waiting may risk permanent neurological injury. Loss of bladder or bowel control in the setting of a herniated disc is a surgical emergency. And in patients with severe intractable pain who have clearly failed conservative measures, earlier surgery is a reasonable and well-supported choice.
Rishi N. Sheth, MD will review your MRI, your clinical examination, your symptoms, and your treatment history together to give you an honest and specific recommendation about whether microdiscectomy is the right next step for you.
What Happens During a Minimally Invasive Microdiscectomy.
Understanding what the procedure involves helps patients feel prepared and removes the anxiety that comes from the unknown. Here is what a minimally invasive microdiscectomy at Spine Care New Jersey looks like from start to finish.
Before Surgery
Patients receive preoperative instructions regarding eating, drinking, and medications in the days before the procedure. A preoperative assessment ensures that there are no medical issues that need to be optimized before surgery. Most microdiscectomies are performed under general anesthesia, though spinal anesthesia is an option for some patients.
The Procedure
The patient is positioned face down on the operating table with the lower back accessible. Rishi N. Sheth, MD makes a small incision in the skin over the affected disc level. Using a tubular retractor system, the muscles alongside the spine are gently moved aside rather than cut, which is a key advantage of the minimally invasive approach and one of the main reasons recovery is faster than with conventional open surgery.
The surgical microscope is then positioned to give Dr. Sheth a magnified, bright view of the operative field. A small amount of bone may be removed to access the disc and nerve root. The herniated disc fragment that is pressing on the nerve is carefully identified and removed. Dr. Sheth inspects the nerve root to confirm it is fully decompressed and free of any remaining compression before closing. The entire procedure typically takes between 45 minutes and 90 minutes depending on the complexity of the case.
After Surgery
Most patients are up and walking within a few hours of the procedure. Discharge home typically occurs the same afternoon. Patients go home with specific activity guidelines, wound care instructions, and a clear plan for follow-up and return to activity.
What to Expect During Microdiscectomy Recovery — Week by Week.
One of the most common questions patients ask before microdiscectomy is how long the recovery takes. The honest answer is that it varies somewhat depending on the individual, but the general timeline for minimally invasive microdiscectomy is among the fastest of any spine surgical procedure.
In the first few days after surgery, most patients are surprised by how manageable the postoperative discomfort is. The incision site will be sore, and some patients experience temporary muscle aching from the surgical position. Importantly, the radiating leg pain that brought most patients to surgery is typically gone or dramatically reduced from the moment they wake up from anesthesia. Oral pain medications are prescribed for the first week and are usually tapered quickly as the postoperative discomfort resolves.
By the end of the first week, most patients are moving around the house comfortably, managing personal care independently, and taking short walks outside. Driving is typically not permitted for the first one to two weeks, primarily due to the sedating effects of any pain medications and the reflex response to sudden braking.
Return to sedentary work, including desk work and computer-based jobs, typically occurs between one and two weeks after surgery. Patients with more physically demanding occupations that involve lifting, bending, or prolonged standing generally return to work in four to six weeks, depending on the specific demands of their job.
Return to light recreational activity including walking, swimming, and cycling typically begins at four to six weeks. Return to more vigorous physical activity and sport varies but generally occurs between six and twelve weeks for most patients.
Physical therapy is recommended after microdiscectomy for most patients, typically beginning two to four weeks after surgery. A structured rehabilitation program helps restore core strength, improve spinal stability, and reduce the risk of recurrent disc herniation. Rishi N. Sheth, MD coordinates physical therapy as part of every microdiscectomy patient's postoperative plan.
Microdiscectomy Expertise Backed by Fellowship Training and Focused Spine Practice.
Microdiscectomy is a procedure where surgical experience and technique matter considerably. The margin between an excellent outcome and a complication is often measured in millimeters, and the ability to identify and fully decompress the nerve root while avoiding injury to the surrounding structures comes from deep, focused experience with spinal surgery.
Rishi N. Sheth, MD's training in spine surgery at the University of Miami under Allan Levi, MD and subsequent fellowship at Memorial Sloan Kettering Cancer Center provided him with a
technical foundation in spinal microsurgery that directly informs how he performs microdiscectomy. His exclusive focus on spine surgery means that microdiscectomy is not an occasional procedure performed between other surgical cases — it is a central part of his surgical practice.
Patients who choose Spine Care New Jersey for microdiscectomy also benefit from genuine continuity of care. Dr. Sheth performs the preoperative consultation, performs the surgery himself, and sees patients through every postoperative appointment. There are no handoffs between providers, no physician assistants conducting the final evaluation, and no surprises about who will be in the operating room.
For patients who have already been told they need microdiscectomy by another surgeon and want a second opinion before proceeding, the free MRI review at Spine Care New Jersey provides an opportunity to hear an independent, expert assessment from a fellowship-trained spine neurosurgeon before making a final decision.
Common Questions About Microdiscectomy at Spine Care New Jersey.
Spine Care New Jersey in Bergen County is led by Rishi N. Sheth, MD, a board-certified spine neurosurgeon fellowship-trained at Memorial Sloan Kettering Cancer Center who performs minimally invasive microdiscectomy as a core part of his surgical practice. Every procedure is performed personally by Dr. Sheth on an outpatient basis with same-day discharge. New patients throughout Bergen County and northern New Jersey can book a consultation or request a free MRI review to determine whether microdiscectomy is appropriate for their herniated disc.
Most patients go home the same day as their microdiscectomy. Radiating leg pain typically resolves immediately after surgery. Return to desk work occurs within one to two weeks. More physical occupations and recreational activities resume within four to eight weeks. Physical therapy usually begins two to four weeks after surgery. The minimally invasive approach used by Rishi N. Sheth, MD means faster recovery than traditional open microdiscectomy due to significantly less disruption of the surrounding muscles.
Look for a spine surgeon who is board-certified by the American Board of Neurological Surgery or the American Board of Orthopaedic Surgery, fellowship-trained specifically in spine surgery, and who performs microdiscectomy regularly as a core part of their practice rather than occasionally. Rishi N. Sheth, MD at Spine Care New Jersey in Bergen County is board-certified, fellowship-trained at the University of Miami and Memorial Sloan Kettering Cancer Center, and performs all microdiscectomy procedures personally using minimally invasive techniques.
New patients can book a consultation directly through the contact form at spinecarenj.com or by calling the Spine Care New Jersey office in Maywood, Bergen County. Appointments are typically available within the same week of inquiry. Patients with existing MRI imaging can also request a free MRI review before their first visit, allowing Dr. Sheth to begin evaluating whether microdiscectomy is the appropriate treatment before the consultation appointment.
Microdiscectomy has one of the highest success rates of any spine surgical procedure. Published studies consistently report that 85 to 95 percent of patients experience significant or complete relief from radiating leg pain following surgery. Outcomes are best in patients with clear nerve root compression on MRI and a clinical presentation that correlates with the imaging findings. Results for isolated back pain without radiating leg symptoms are less predictable. Dr. Sheth will give you a realistic assessment of your expected outcome based on your specific clinical picture during consultation