Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
If spinal nerve compression is causing ongoing pain, numbness, or weakness, surgery may be considered when non-surgical treatments are no longer effective. Microdiscectomy and laminectomy are two commonly recommended spine procedures, each designed to relieve pressure on the nerves but in different ways. Knowing how these surgeries differ and which conditions they are best suited for can help you better understand your treatment options and what to expect from surgery.
Why Nerve Compression Happens
- Herniated discs, where disc material bulges or ruptures and presses on a nerve
- Spinal stenosis, which involves the narrowing of the spinal canal or nerve exit pathways
- Bone spurs, often related to arthritis, that encroach on nerve spaces
- Ligament thickening, which can reduce the space within the spinal canal over time
- Vertebral slippage (spondylolisthesis), where one vertebra shifts out of position and compresses nearby nerves
What Is a Microdiscectomy and How Does It Work?
A microdiscectomy is a minimally invasive procedure used to relieve pain and improve mobility caused by a herniated or bulging intervertebral disc. The surgery targets only the portion of the disc that is pressing on a spinal nerve root, preserving as much normal tissue as possible.
During the procedure, the surgeon makes a small incision near the affected area and uses specialised instruments, often with the aid of a microscope, to gently move the muscles aside and access the spine. The herniated disc material causing nerve compression is then carefully removed, relieving pressure on the nerve and reducing symptoms. The incision is closed with sutures or surgical glue, which typically allows for a faster recovery compared to traditional open surgery.
When Microdiscectomy Is Typically Considered
A microdiscectomy may be considered when a herniated disc is responsible for ongoing nerve-related symptoms. This procedure is often discussed if:
- Persistent leg pain results from a lumbar disc herniation
- Numbness, tingling or weakness develops due to nerve compression
- Symptoms do not improve despite conservative treatments such as medication, physiotherapy or injections
- Imaging studies confirm that a disc fragment is pressing on a nerve root
What Is a Laminectomy and How Does It Work?
A laminectomy is a surgical procedure performed to relieve pressure on the spinal cord or nerves, commonly due to spinal stenosis or severe nerve compression. It involves removing all or part of the lamina, the bony arch at the back of the spinal canal, to create more space and reduce symptoms such as pain, numbness or weakness.
During the procedure, the surgeon makes an incision over the affected area of the spine and gently moves the surrounding muscles aside to access the vertebrae. The lamina is then removed, and other contributing structures, such as thickened ligaments, may also be trimmed if necessary. Once adequate decompression is achieved, the muscles are returned to their original position and the incision is closed with sutures.
When Laminectomy Is Typically Considered
A laminectomy may be considered when spinal canal narrowing leads to ongoing nerve-related symptoms. This procedure is often discussed if:
- Spinal stenosis causes leg pain, heaviness or numbness
- Symptoms worsen with standing or walking but improve when sitting or bending forward
- Weakness develops as a result of nerve compression
- Imaging studies show a significant narrowing of the spinal canal
Factors to Consider When Choosing Surgery
Your surgeon will take several factors into consideration when deciding what type of surgery or technique to use. Common factors include:
- Severity and Location of Symptoms: The intensity of pain, numbness or weakness, as well as where these symptoms occur along the spine.
- Type of Spinal Condition: The underlying cause of nerve compression, such as a herniated disc, spinal stenosis, bone spur or other structural issue.
- Overall Health and Medical History: Existing medical conditions, prior spine surgeries and general fitness for surgery.
- Recovery Goals: Expectations regarding speed of recovery, return to daily activities, and long-term mobility.
Risks and Potential Complications: Possible s
Let Oxford Spine Tailor an Effective Treatment for You
If you are experiencing persistent pain, numbness or weakness despite non-surgical treatment, our specialised team at Oxford Spine & Neurosurgery Centre can help to clarify your diagnosis and determine whether surgery is appropriate. A personalised assessment allows your surgeon to recommend the most suitable treatment approach for your condition and long-term spinal health. Contact us today to make an appointment.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
