Microdiscectomy in Singapore

Microdiscectomy is a spinal surgery that relieves nerve pain caused by a herniated disc. If non-surgical treatments fail, the procedure removes the disc portion pressing on a nerve through a small incision. This reduces tissue damage, eases nerve pressure, and improves symptoms.

Dr Ng Zhi Xu
Dr Ng Zhi Xu
Senior Consultant Neurosurgeon
Dr Roy Koh Kiok Miang
Dr Roy Koh Kiok Miang
Senior Consultant Neurosurgeon
Dr Victor Wang Tzong-Jing
Dr Victor Wang Tzong-Jing
Senior Consultant Orthopaedic Surgeon, Spine & Orthopaedic Surgery

Indications for Microdiscectomy

Microdiscectomy may be recommended when the following conditions are present and non-surgical treatments have not been effective:

  • Herniated disc with nerve compression: When disc material presses on a nerve root, causing pain that radiates down the leg.
  • Persistent sciatica: Leg pain that travels along the sciatic nerve pathway and hasn’t improved with non-surgical treatments over 6-12 weeks.
  • Neurological symptoms: Weakness, numbness, or tingling in the leg or foot that affects daily activities and mobility.
  • Failed conservative treatment: When physiotherapy, medications, and injections haven’t provided meaningful improvement after an appropriate trial period.
  • Progressive neurological deficit: Worsening weakness or loss of function that requires prompt intervention to prevent permanent damage.

Benefits of Microdisectomy

Microdiscectomy offers several advantages for patients with nerve compression from a herniated disc:

Relief from leg pain and sciatica

Most patients experience significant reduction in radiating leg pain within weeks of the procedure.

Improved mobility and function

Reduced nerve compression allows patients to return to walking, sitting, and standing with greater comfort.

Minimal disruption to spinal structures

The procedure preserves the majority of the disc, maintaining spinal stability and normal biomechanics.

Faster recovery compared to traditional open surgery

Small incisions and minimal tissue disruption allow shorter hospital stays and quicker return to activities.

Resolution of neurological symptoms

Numbness, tingling, and weakness often improve as pressure is removed from the affected nerve root.

Microdisectomy Surgical Techniques in Singapore

Performed through a small incision using magnification and specialised instruments to remove the herniated disc material.

Uses a tiny camera and instruments inserted through an even smaller incision, allowing for precise visualisation and removal of disc fragments.

Employs a tubular retractor system that creates a small working channel, minimising disruption to surrounding muscles and tissues.

The most common method, accessing the disc from the back of the spine through the natural space between vertebrae.

Preparing for Surgery

Proper preparation helps ensure the procedure goes smoothly and supports your recovery.

  • Pre-operative medical assessment: Includes blood tests, heart checks, and a review of your medical history.
  • Medication review and adjustments: All medications, supplements, and herbal remedies, will be reviewed. You will be advised on which to continue or temporarily stop before surgery.
  • Imaging confirmation: Recent MRI or CT scans will be reviewed to confirm the exact location and extent of the disc herniation requiring treatment.
  • Fasting instructions: You will need to avoid eating and drinking for a specified period before surgery, typically from midnight the night before your procedure.
  • Pre-operative hygiene: You may be asked to shower with antibacterial soap the night before and morning of surgery to reduce infection risk.
  • Arrangements for discharge: Plan for someone to drive you home and stay with you for the first 24 hours following surgery.

Step-by-Step Procedure

Microdiscectomy typically takes one to two hours and involves the following steps:

General anaesthesia

You will be under general anaesthesia to ensure you are unconscious and pain-free during the procedure.

Patient positioning

You’ll be positioned face-down on a special surgical table that allows optimal access to your spine.

Surgical incision

A small incision, 2-3 centimetres long, is made over the affected area of your spine.

Muscle separation

The back muscles are gently moved aside to expose the bone structure without cutting through muscle fibres.

Bone preparation

A small amount of bone may be removed to create adequate space for accessing the herniated disc material.

Disc material removal

Using magnification and specialised instruments, the neurosurgeon carefully removes the portion of disc material pressing on the nerve.

Wound closure

The incision is closed in layers using dissolvable stitches, and a sterile dressing is applied to protect the surgical site.

After Care and Recovery

Post-operative monitoring: You will be observed in the recovery area until the anaesthesia wears off and your condition is stable.

Pain management: Medication will be provided to keep you comfortable, and you’ll receive instructions for managing discomfort at home.

Early mobilisation: Most patients are encouraged to walk within a few hours of surgery

Discharge planning: Many patients go home the same day or after an overnight stay, depending on their recovery progress.

First week: Begin walking gently while avoiding bending, lifting, or twisting.

2-4 weeks: Gradual increase in activity levels with continued restrictions on heavy lifting and strenuous activities.

6-12 weeks: Most patients can return to normal activities and work, though this varies depending on individual healing and job requirements.

3-6 months: Full recovery is typically achieved, with return to all activities including sports and heavy physical work.

Wound check appointment: A follow-up visit within 1-2 weeks to assess healing and remove any non-dissolvable stitches if used.

Progress evaluation: Regular appointments with your neurosurgeon to monitor recovery and address any concerns about symptoms or function.

Potential Risks and Complications

As with any surgical procedure, microdiscectomy carries some risks, though serious complications are uncommon. These may include infection at the surgical site, bleeding, temporary numbness or weakness, recurrence of disc herniation, and rare complications such as nerve damage or spinal fluid leakage.

Your neurosurgeon will discuss these risks with you before surgery and take measures to minimise them. Most patients experience significant improvement in their symptoms with minimal complications.

Dr Ng Zhi Xu

Dr Ng Zhi Xu

Senior Consultant Neurosurgeon

Dr Ng is a fully registered specialist in Neurosurgery, with sub-specialty interests in neurotrauma, neuro-oncology, and spine surgery.

  • Bachelor of Medicine and Bachelor of Surgery (MBBS) from Yong Loo Lin School of Medicine, National University of Singapore 2007
  • Basic Surgical Training at TTSH and KTPH 2008-2010
  • Basic Neurosurgical training NUH and KTPH 2010-2012 (Service Registrar)
  • Advanced Neurosurgical training and residency NUH 2013 – 2017
  • Fellowship training in Neurosurgery at Addenbrooke’s Hospital, Cambridge, United Kingdom from 2015 – 2016
  • Intercollegiate Fellowship of Royal Colleges of Surgery (FRCSGlasg) for Neurosurgery, 2016

During his term in KTPH, he developed a deep interest in teaching and organized numerous General Practice (GP) and nursing forums to promote the sharing of common neurosurgical conditions. While there, he was also the director for residency teaching in KTPH.

Dr Ng has done research collaborations with both National Neuroscience Institute (NNI) and NUH. He currently has ongoing research grants with NUH, which focuses on developing modified stem cell treatment for resistant brain cancers.

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Dr Roy Koh Kiok Miang

Dr Roy Koh Kiok Miang

Senior Consultant Neurosurgeon

Dr Roy Koh has expertise to manage a wide variety of neurosurgical and spinal problems. He was the first Neurosurgical Spine Consultant at KTPH and also performed Singapore’s first minimally invasive removal of a Spinal Tumor.

  • MBBS, National University of Singapore (NUS) in 2000
  • Basic Surgical Training in 2004
  • MRCS (Edin) and Master in Medicine(Surgery) in 2006
  • Neurosurgical Advanced Surgical training in 2008
  • Fellowship with Neurosurgical Department in Addenbrookes Hospital, Cambridge

Dr Koh has been active in pursuing his love for neurosurgery and spine surgery. He has also been an invited surgeon to places like India and visiting specialist surgeon for the Vietnamese Neurosurgical Congress in 2013, showcasing his new minimally invasive spine techniques to our neighbours.

Dr Koh is an Adjunct Assistant Professor in the Yong Loo Lin School of Medicine, where he is an MBBS examiner, and actively involved in training of the next generation of doctors.

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Dr Victor Wang Tzong-Jing

Dr Victor Wang Tzong-Jing

Senior Consultant Orthopaedic Surgeon, Spine & Orthopaedic Surgery

Dr Victor Wang is a fellowship-trained Consultant Orthopaedic Surgeon who sub-specialises in Spine surgery.

  • MBBS (Singapore)
  • MRCS (Edin)
  • MMed (Ortho)
  • FRCSEd (Ortho)

His practice interests include Minimally invasive spine surgery, Navigation/Robot-assisted spine surgeries, Intervertebral disc-related diseases and Adult Spinal Deformities.

A keen believer in the application of technology in evidencebased practice, Dr Wang has vast experience in utilising Computer Navigation for major spine surgeries.

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    Microdiscectomy

    Frequently Asked
    Questions

    How long will I need to take off work?

    This depends on your job requirements, but office workers typically return within 2-3 weeks, while those with physically demanding jobs may need 6-8 weeks off work.

    Will the disc herniation come back after surgery?

    Recurrence occurs in approximately 5-10% of patients, usually within the first two years, though many cases can be managed without additional surgery.

    Can I drive after microdiscectomy surgery?

    Avoid driving for at least one week or until you can brake safely without discomfort, typically 1-2 weeks after surgery.

    What activities should I avoid during recovery?

    Avoid bending, lifting heavy objects, or twisting your spine for the first 6 weeks to allow proper healing of the surgical site.

    Will I need physiotherapy after the procedure?

    While not always necessary, many patients benefit from physiotherapy to rebuild strength and flexibility, particularly if they’ve been inactive due to pain before surgery.

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