The goal of surgery is to make the herniated disc stop pressing on and irritating the nerves, causing symptoms of pain and weakness. The most common procedure is called a "discectomy" or "partial discectomy," in which part of the herniated disc is removed. In order to see the disc clearly, sometimes it is necessary to remove a small portion of the lamina, the bone behind the disc. Bone removal may be minimal (hemi-laminotomy) or more extensive (hemi-laminectomy). Some surgeons use an endoscope or microscope in some cases.
Discectomy can be done under either local, spinal or general anesthesia. The patient lays face down on the operating table, generally in a kneeling position. A small incision is made in the skin over the herniated disc and the muscles over the spine are pulled back from the bone. A small amount of bone may be removed so the surgeon can see the compressed nerve. The herniated disc and any loose pieces are removed until they are no longer pressing on the nerve. Any bone spurs (osteophytes) are also taken out to make sure that the nerve is free of pressure.
Surgery may not return leg strength to normal, but it can stop your leg from getting weaker, and relieve leg pain. Surgery is usually recommended for relief of leg pain (greater than 90% success); surgery is less effective in relieving back pain.