Endoscopic Microdiscectomy

Overview

Endoscopic microdiscectomy is the least invasive surgical option for lumbar disc herniations causing sciatica and leg pain. Through an incision smaller than a fingertip, Dr. Basques inserts an endoscope — a thin tube with a high-definition camera and light — directly to the herniated disc. Using specialized instruments through the same working channel, he removes only the herniated disc fragment compressing the nerve root, leaving healthy disc and surrounding tissue completely undisturbed. Because there is virtually no muscle disruption, most patients experience immediate leg pain relief and go home the same day. This is a true outpatient procedure with a faster recovery than traditional microdiscectomy.

How It Works

The procedure is performed under local anesthesia with sedation (not general anesthesia in most cases). Dr. Basques makes a tiny incision (approximately 7mm — smaller than a pencil eraser) in the lower back. Under real-time X-ray guidance, a dilator gently spreads the muscles apart without cutting them. The endoscope is inserted through this working channel, providing a magnified, illuminated view of the disc and nerve on a high-definition monitor. Using micro-instruments, the herniated disc fragment is identified and removed, decompressing the nerve. The entire procedure typically takes 30–60 minutes, and the incision is closed with a single stitch or surgical tape.

Benefits

Who Is a Candidate?

Ideal candidates have a lumbar disc herniation causing sciatica (leg pain, numbness, or weakness) that has not responded to 6–8 weeks of non-surgical treatment including physical therapy, anti-inflammatory medications, and epidural steroid injections. Patients with contained disc herniations (not large free fragments) at accessible levels are best suited. Dr. Basques evaluates each patient's MRI and symptoms to determine if endoscopic microdiscectomy is the right option.

Recovery & Aftercare

Most patients notice immediate relief of leg pain upon waking from the procedure. They are typically discharged home within 2–4 hours after surgery. Light activities can resume within days. Most patients return to desk work within 1–2 weeks and full physical activities within 4–6 weeks. No heavy lifting or bending for the first few weeks. Dr. Basques and his team provide a detailed recovery plan tailored to each patient.

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