HERNIATED DISC OPERATION

What exactly happens during a herniated disc operation in the lower back? What can you expect in terms of recovery? Are there any risks involved? What does the healing process look like, and what have previous patients experienced? Here's what to expect if surgery becomes necessary to treat your lumbar disc herniation.

When nothing helps anymore Your hernia is constant and debilitating. It affects not just you, but your loved ones too. Painkillers, physiotherapy, patience — nothing works. Your quality of life has plummeted and everyday life is slipping away. An MRI scan shows the culprit: displaced disc tissue pressing against a nerve. The spinal surgeon recommends micro-surgical removal. Fortunately, you're otherwise healthy, and a short general anaesthetic shouldn't pose a problem.

Surgery on the lumbar spine (lower back)

After a thorough neurological examination to assess nerve function and any signs of weakness, you’ll receive detailed information about the planned procedure. We’re focusing here on the typical herniated disc in the lumbar spine. This is by far the most common spinal surgery: around 85% of procedures involve the lower back, about 10% the cervical spine (neck), and only around 5% the thoracic spine (mid-back).
We’ll first describe what happens on the day of surgery, then go through the potential risks and offer advice and tips for recovery afterwards.

Preparing for surgery: The anaesthetist’s role

The operation is performed under general anaesthesia by an experienced anaesthetist. It’s a minimally invasive procedure requiring only a small skin incision. This means less tissue is disturbed, the wound heals faster, and scarring is minimal.
Beforehand, the anaesthetist will examine you to assess anaesthesia risks. If needed, they may refer you to an internist or cardiologist. The surgery is done with you lying on your stomach. You'll be gently repositioned while asleep. To keep your lungs properly oxygenated in this position, a thin breathing tube is inserted into your windpipe – but only once you're fully asleep. IV lines are also placed so medication can be given.

Preparing for surgery: The anaesthetist’s role

The operation is performed under general anaesthesia by an experienced anaesthetist. It’s a minimally invasive procedure requiring only a small skin incision. This means less tissue is disturbed, the wound heals faster, and scarring is minimal.
Beforehand, the anaesthetist will examine you to assess anaesthesia risks. If needed, they may refer you to an internist or cardiologist. The surgery is done with you lying on your stomach. You'll be gently repositioned while asleep. To keep your lungs properly oxygenated in this position, a thin breathing tube is inserted into your windpipe – but only once you're fully asleep. IV lines are also placed so medication can be given.

Monitoring your wellbeing during the operation

During surgery, a ventilator takes over your breathing. Your heart rate, blood pressure, and oxygen levels are continuously monitored. We even record brain activity (EEG) to ensure you’re fully asleep and comfortable. The anaesthetist works to minimise bleeding so that the surgeon has a clear view of the nerves and disc tissue. Our surgical and anaesthesia teams are highly experienced and work seamlessly together.

Preparing the surgical site

Once you’re deeply asleep and in position, the surgical area is prepared. An X-ray is used to precisely locate the herniated disc beneath the skin so the surgeon can plan the safest route. The skin is disinfected, the area draped with sterile sheets, and only the incision site remains visible. A "time-out" is performed as a final safety check before starting.

Preparing the surgical site

Once you’re deeply asleep and in position, the surgical area is prepared. An X-ray is used to precisely locate the herniated disc beneath the skin so the surgeon can plan the safest route. The skin is disinfected, the area draped with sterile sheets, and only the incision site remains visible. A "time-out" is performed as a final safety check before starting.

Zooming in: The role of the surgical microscope

Zooming in: The role of the surgical microscope A high-powered surgical microscope is used to magnify and illuminate the area. It allows the surgeon to see even deep structures clearly, despite the small incision. The microscope is mounted for stability, freeing the surgeon’s hands to work with extreme precision. This technology ensures safety and accuracy throughout the procedure.

PreThe goal: Removing the hernia and relieving nerve pressure  

The aim of the operation is to free the compressed nerve and relieve pain. Based on your MRI, neurological findings, and X-rays, the surgeon selects the best approach. Sometimes joint thickening (arthrosis) is also present and must be removed first. The surgeon works from the back, carefully navigating around the nerve to reach the disc. The part of the disc pressing on the nerve is removed. Once the nerve is free, it resumes natural movement with your heartbeat and breathing – a good sign that pressure has been relieved. Any bleeding is then controlled.paring the surgical site

PreThe goal: Removing the hernia and relieving nerve pressure  

The aim of the operation is to free the compressed nerve and relieve pain. Based on your MRI, neurological findings, and X-rays, the surgeon selects the best approach. Sometimes joint thickening (arthrosis) is also present and must be removed first. The surgeon works from the back, carefully navigating around the nerve to reach the disc. The part of the disc pressing on the nerve is removed. Once the nerve is free, it resumes natural movement with your heartbeat and breathing – a good sign that pressure has been relieved. Any bleeding is then controlled.paring the surgical site

Closing the wound

Tiny blood vessels are sealed with a fine electric tool. The muscle layer is closed, followed by the deeper tissue and skin. A dressing is applied, and you’re gently turned onto your back. You then wake up and are monitored in recovery. Once you’re stable, breathing well, and alert, you’re taken to the ward. Most patients are able to stand and go to the toilet on their own after about five hours.

Possible risks of the operation

Surgical risks can be divided into several categories. First, there are general risks unrelated to the operation itself, such as diabetes, high blood pressure, blood-thinning medication, or anaesthetic issues related to asthma or sleep apnoea.
There are also risks linked to your positioning during surgery. Lying on your stomach can cause pressure points or skin irritation if care isn’t taken. Infections can occur if bacteria enter through the incision, which is why shorter surgery times reduce this risk. Preventive antibiotics are often given.
During the procedure, small blood vessels are cauterised to minimise bleeding. On average, blood loss is roughly the volume of a mug. In rare cases, a sealed vessel may reopen and form a small (harmless) haematoma.

Possible risks of the operation

Surgical risks can be divided into several categories. First, there are general risks unrelated to the operation itself, such as diabetes, high blood pressure, blood-thinning medication, or anaesthetic issues related to asthma or sleep apnoea.
There are also risks linked to your positioning during surgery. Lying on your stomach can cause pressure points or skin irritation if care isn’t taken. Infections can occur if bacteria enter through the incision, which is why shorter surgery times reduce this risk. Preventive antibiotics are often given.
During the procedure, small blood vessels are cauterised to minimise bleeding. On average, blood loss is roughly the volume of a mug. In rare cases, a sealed vessel may reopen and form a small (harmless) haematoma.

In the lower back, the spinal cord transitions into a bundle of nerves, meaning there's no actual spinal cord in the lumbar region. Nerve fibres tolerate manipulation better than the spinal cord, which makes nerve injury during this surgery very rare. The nerve sheath (dura) is like a bicycle inner tube — it can be patched if needed.
The goal is to remove the current herniation and free the nerve, but a future herniation (recurrence) is possible. You’ll be fully informed about risks beforehand, and this written explanation complements, but does not replace, your official informed consent form.

What happens after the operation?

The aim of the operation is to eliminate the current pain with minimal risk and restore your quality of life quickly. Aftercare varies between individuals. In our experience, a swift return to daily life gives better results than prolonged rest. Fear and avoidance tend to prolong recovery. Our advice? Put this painful chapter behind you and get back to enjoying life.
For many, this is also an opportunity to make positive changes — more movement, less weight, and lower stress all support your wellbeing. Recovering from a hernia is also a great moment to start building strength with professional guidance if needed.

“There’s no perfect way to avoid a hernia. It can happen to anyone — even more than once.”
Drs. Patrick Simons
“There’s no perfect way to avoid a hernia. It can happen to anyone — even more than once.”
Drs. Patrick Simons
The MVZ RÜCKENDOC team in Cologne is specialized in treating herniated discs
and spinal stenosis of the lower back and neck.
More than 22.000 successful spinal surgeries performed.
More than 1000 operations on international patients each year.

Expertise provides assurance!

Our multidisciplinary team is dedicated to managing herniated discs and spinal stenosis
in both the lower back and neck.
NO waiting list

You decide the urgency of our help; we ensure no delays since waiting times
simply don’t exist.

highly specialized

With over 22,000 successful surgeries under our belt, the RÜCKENDOC team carries out about 1,500 spinal operations each year.​

microdiscectomy

By employing our perfected 3D microscopy technology, we ensure you receive the best minimally invasive surgical opportunities.

Frequently Asked Questions about
MVZ RÜCKENDOC

What is the speciality of MVZ RÜCKENDOC?
Our specialisation encompasses treatments for disc herniations, cervical disc issues, the removal of spinal canal stenoses, and the stabilisation of the spine. Since 1994, we have focused on managing both chronic and acute back pain.
Where is MVZ RÜCKENDOC located?
Our main centre is located in Cologne, with additional operating theaters in Düsseldorf and Krefeld. We have additional consultation hours in the Netherlands.
How many spinal procedures does MVZ RÜCKENDOC perform?
Annually, MVZ RÜCKENDOC undertakes approximately 1,500 spinal procedures. Since our inception in 1994, we have performed over 22,000 procedures, making us the most experienced herniated disc centre for the Netherlands.
How is a herniated disc treated at MVZ RÜCKENDOC?
Once we have identified the cause of your discomfort, we discuss the treatment options with you and develop a tailored, structured treatment plan. This may involve both surgical and conservative methods.
How can I schedule a consultation at MVZ RÜCKENDOC?
The best way to contact MVZ RÜCKENDOC is by filling in our contact form. It ensures you one of our spinal surgeons will reply within 24 hours. If you already have a MRI scan, this scan will be reviewed for free.
What is the typical recovery time following a 3D microdiscectomy?
Our team will provide you with a detailed post-operative care plan to support a smooth and efficient recovery. Most UK patients remain in our clinic for one night and two additional nights in a hotel nearby before flying back to the UK.

Pain free in 3 simple steps

Our international team is ready to help you
1
Contact us

fill in the contact form and one of our specialists will respond within 24 hours. A consultation can be planed within a week.

2
Physical exam and MRI

Besides a detailed interview a neurological examination take place and a MRI is made. Your therapeutic options are discussed right away.
Our German efficiency makes it possible to do this with in a few hours

3
surgery

If a spinal surgery is the best option you will meet our anesthesiologists right away and the operation can be performed within a day or two.