Comparing the Long and Short of Disc Herniation Surgeries
Doctors are always looking for ways to limit the length of the incision needed for surgery. Shorter incisions generally mean less damage to surrounding tissues. They usually heal more quickly. But shorter incisions are not always better. Larger incisions can help doctors see and reach structures better.

That's where research like this comes in. This doctor looked at 114 patients. All of them had surgery for a herniated disc in the low back one year earlier. All patients had surgery on only one side of a single spinal level. The same surgeon operated on all the patients.

But one group had microsurgery using a special microscope to help surgeons view the surgery site. The other group had macrodiscectomy. This traditional approach uses a longer, open incision and does not require a microscope. More of the surrounding bone is removed in the macrodiscectomy.

For the most part, the groups both did well. About 90 percent of all patients had good or excellent results. Both groups reported less pain and more strength. But there were differences. The group who had macrodiscectomy had longer scars. They also spent much less time in the operating room--an average of 25 minutes, compared to 59 minutes for microdiscectomies. The author notes that the shorter operating time was because the surgeon did not need to use a microscope.

However, the group who had the microdiscectomy saw some major benefits. They used less pain medication. They also returned to normal life faster. Of these patients, 85 percent returned to normal activities within a month. This compares to 59 percent of the other group. The author concludes that, in the case of simple herniated discs in the low back, smaller incisions are most often the way to go.
Kudret Türeyen, MD. One-Level One-Sided Lumbar Disc Surgery with and without Microscopic Assistance: One-Year Outcome in 114 Consecutive Patients. In Journal of Neurosurgery: Spine. October 2003. Vol. 99. No. 3. Pp. 247-250.