Microdiscectomy at Apollo Hospitals, Lucknow

Why Patients Choose Apollo Hospitals Lucknow for Microdiscectomy

• A four-decade legacy: Apollo Hospitals began in 1983 in Chennai and has grown into one of Asia's largest integrated healthcare groups, with more than 70 hospitals and over 10,000 beds across the network. Apollomedics Super Speciality Hospital, Lucknow serves as the group's tertiary referral centre for Uttar Pradesh, with over 300 beds and a dedicated Institute of Neurosciences and Institute of Orthopaedics and Spine Surgery.
• A combined neuro-spine and orthopaedic spine team: Microdiscectomy at Lucknow is offered by both neurosurgeons and orthopaedic spine surgeons, so the patient is assessed by the specialty most appropriate to the pathology rather than by whoever is available. The spine team works alongside neurology, pain medicine, rheumatology, endocrinology and physiatry, which matters when back pain overlaps with diabetes, osteoporosis or inflammatory disease.
• Depth of experience: The neurosciences and spine faculty are drawn from senior consultants with post-doctoral training (DM, MCh, DNB, MS Orthopaedics) and, between them, several decades of combined operative experience in degenerative spine surgery. Individual surgeon profiles, qualifications and years of practice are published on the Apollo Hospitals Lucknow website and can be verified before you book.
• Technology used routinely, not occasionally: high-field MRI and multi-slice CT for pre-operative planning, operating microscopes and tubular retractor systems for muscle-sparing access, C-arm fluoroscopy for level confirmation, intraoperative neuromonitoring where indicated, and modular laminar-flow operating theatres.
• Round-the-clock support services: in-house critical care, 24-hour blood bank, radiology and laboratory, and an emergency department, so a cauda equina syndrome or rapidly progressive foot drop can be worked up and operated without transfer to another facility.
• Structured, tailored rehabilitation: separate pathways for the young sportsperson or gym-goer, for the desk-bound professional, for the manual labourer or farmer, for older adults with coexisting stenosis or osteoporosis, and for adolescents with disc herniation ? with counselling built around Indian daily habits such as floor sitting, squatting and Indian-style toilets.
• Whole-family approach: attendant-friendly wards recognising the reality of joint-family caregiving, dietetics input for diabetic and vegetarian patients, and a single point of contact for insurance and TPA paperwork.

Overview

Microdiscectomy is a minimally invasive surgical procedure designed to relieve pressure on spinal nerves caused by herniated discs. At Apollo Hospitals Lucknow, we pride ourselves on our reputation for excellence in spinal care, utilising current technology and advanced surgical techniques. Our team of skilled neurosurgeons and orthopaedic specialists is dedicated to providing personalised care tailored to each patient's needs. With a focus on patient trust and honest, evidence-based decision-making, Apollo Hospitals Lucknow is among the well-established centres for microdiscectomy in the region.

In practical terms, the surgeon works through an incision of roughly 2?3 cm, uses an operating microscope or endoscope to magnify the surgical field, gently retracts the muscle rather than stripping it, and removes only the fragment of disc that is compressing the nerve root. The disc itself is not replaced. The aim of the operation is to relieve nerve-root pain (sciatica) and neurological symptoms in the leg ? it is a decompression, not a repair of the spine.

Why Microdiscectomy is Necessary

Microdiscectomy is often necessary for patients suffering from severe back pain, leg pain, or neurological symptoms due to a herniated disc. When conservative treatments such as physical therapy, medication, or injections fail to provide relief, this procedure can be a vital next step. The surgery involves the removal of a small portion of the herniated disc that is pressing on the spinal nerve, alleviating pain and restoring function.

The benefits of microdiscectomy are significant. Patients often experience early relief from leg pain, improved mobility, and a quicker return to daily activities. The minimally invasive nature of the procedure means smaller incisions, reduced scarring, and a shorter recovery time compared to traditional open surgery. At Apollo Hospitals Lucknow, we use advanced imaging and surgical techniques to support precision and safety.

It is worth being clear about what the surgery targets. Radiating leg pain, numbness and weakness respond better than central low back pain. Patients whose dominant complaint is back pain alone are usually better served by non-surgical care, and this is discussed openly during consultation.

Risks of Delay

Delaying microdiscectomy can, in some situations, lead to serious complications. Prolonged pressure on the spinal nerves may result in chronic pain, muscle weakness, and, uncommonly, persistent nerve damage. Patients may also experience worsening symptoms, which can significantly affect quality of life. Timely intervention matters most where there is progressive weakness, and it is urgent where there is bladder or bowel disturbance with saddle numbness (cauda equina syndrome), which is treated as a surgical emergency.

Equally, it is honest to state that most disc herniations improve without surgery over six to twelve weeks, and that delay in the absence of red flags does not usually cause permanent harm. At Apollo Hospitals Lucknow, we emphasise early diagnosis so that the timing of any intervention is a considered decision rather than a rushed one.

Benefits of Microdiscectomy

• Pain Relief: Most patients experience meaningful reduction in leg pain soon after the procedure, allowing a return to normal activities.
• Improved Mobility: By relieving nerve pressure, microdiscectomy can restore walking distance and function, enabling patients to resume activities they had avoided because of pain.
• Minimally Invasive: The procedure is performed through a small incision, resulting in less tissue damage, less post-operative pain, and quicker recovery.
• Shorter Hospital Stay: Many patients go home the same day or the next day after surgery, minimising disruption to work and family life.
• Favourable Success Rate: Published series report good to excellent relief of sciatica in roughly 80?90% of appropriately selected patients, although results vary with the individual and recurrence is possible.

At Apollo Hospitals Lucknow, our commitment is to careful patient selection so that surgery is offered to those most likely to benefit.

Preparation and Recovery

Preparing for surgery

1. Preoperative Consultation: A thorough consultation with your surgeon to discuss medical history, current symptoms, and all medications you take, including Ayurvedic, homeopathic and over-the-counter preparations.
2. Preoperative Testing: Imaging studies, blood tests, ECG, chest imaging and, where relevant, cardiology or physician clearance to confirm you are a suitable candidate.
3. Medication Management: Follow instructions on stopping blood thinners such as aspirin, clopidogrel or warfarin, and on anti-inflammatory drugs. Diabetes and blood pressure medicines are adjusted, not simply stopped.
4. Arrange for Support: Plan for someone to accompany you to hospital and assist you at home in the first week.
5. Follow Preoperative Instructions: Adhere to fasting and dietary instructions, skin preparation and bathing advice, and stop smoking or tobacco/gutkha use as early as possible before surgery.

Recovery tips

• Rest and Relaxation: Allow the body time to heal, but avoid prolonged bed rest ? short, frequent walks are encouraged from day one.
• Gradual Return to Activity: Follow your surgeon's guidance on resuming daily activities. Avoid heavy lifting, repeated bending and twisting until cleared.
• Pain Management: Use prescribed medication as directed and report any increase in pain or new weakness.
• Physical Therapy: Structured rehabilitation, usually started around four to six weeks, to strengthen the trunk and hip muscles and restore movement confidence.
• Follow-Up Appointments: Attend all reviews so wound healing, neurological recovery and rehabilitation progress can be monitored.

At Apollo Hospitals Lucknow, our team guides you through each step of preparation and recovery.

What Current Guidelines Say

Decision-making for lumbar disc herniation at Apollo Hospitals Lucknow follows the direction set by Indian and international specialty bodies rather than any single surgeon's preference.

• The Association of Spine Surgeons of India (ASSI), through its textbook ASSI Textbook of Spinal Infections and Degenerative Disorders and its annual instructional courses, endorses a trial of non-operative care of about six weeks for lumbar disc herniation with radiculopathy, reserving surgery for persistent disabling radicular pain, progressive motor deficit, or cauda equina syndrome. ASSI's more recent teaching has moved toward accepting tubular/microendoscopic and full-endoscopic discectomy as clinically equivalent alternatives to open microdiscectomy in trained hands, rather than treating open microdiscectomy as the only standard.
• The North American Spine Society (NASS) Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy, revised second edition (2012, with subsequent NASS coverage updates), remains the most cited evidence synthesis. It supports discectomy for patients with confirmed herniation and correlating radiculopathy who have not improved with four to six weeks of non-operative care, and notes that surgery gives faster relief than continued conservative care, with the difference narrowing over one to two years.
• NICE guideline NG59 (Low back pain and sciatica in over 16s, 2016, last reviewed 2020) recommends against routine imaging in non-specialist settings, advises against traction and against spinal injections for low back pain, and reserves decompression for sciatica that fails non-surgical management. Notably, NG59 does not recommend routine use of paracetamol alone or opioids for sciatica, a change from older practice.
• Recent practice shifts that patients should know about: routine post-operative bracing and prolonged bed rest are no longer advised; early mobilisation on the day of surgery is standard; day-care and 23-hour-stay microdiscectomy are now accepted where home support is adequate; and prophylactic fusion is not recommended for a first-time single-level disc herniation.
• MRI is the imaging investigation of choice. Surgery is planned on the basis of imaging that matches the clinical picture ? an incidental disc bulge on MRI without corresponding symptoms is not an indication to operate.

Timing of Surgery and the Pre-Procedure Phase

Most patients pass through three phases before the operating theatre.

1. Observation and active conservative care (weeks 0?6): analgesia, neuropathic pain medication where needed, activity modification, physiotherapy and education. Around two-thirds of patients improve enough in this window to avoid surgery.
2. Reassessment (weeks 6?12): if disabling leg pain persists, MRI is reviewed against the examination findings. A selective nerve root block may be used both to relieve pain and to confirm which nerve root is responsible.
3. Surgical planning (usually within 1?2 weeks of the decision): anaesthetic assessment, investigations, insurance pre-authorisation and a fixed admission date.

This sequence is set aside when there are red flags. Cauda equina syndrome ? urinary retention or incontinence, faecal incontinence, saddle or perineal numbness, or bilateral leg weakness ? requires emergency assessment and, if confirmed, surgery as soon as feasible, ideally within 24?48 hours of onset. Rapidly progressing foot drop is also treated urgently. If any of these develop, attend an emergency department the same day rather than waiting for an OPD appointment.

Technique Options: A Comparison

The right technique depends on the size, position and character of the herniation, your body habitus, previous surgery, and the surgeon's training. All of these decompress the nerve root; they differ in access.

Procedures Sometimes Performed at the Same Time

Some patients need a little more than removal of the disc fragment. These are discussed as possibilities before surgery so there are no surprises in the consent form.

• Partial laminotomy or facet undercutting ? to open the space over the nerve root when the bony canal is also tight.
• Foraminotomy ? widening the exit tunnel of the nerve root where the compression is lateral.
• Limited decompression for coexisting lateral recess stenosis ? common in patients over 55 with degenerative change alongside the disc.
• Multi-level or bilateral discectomy ? where imaging and symptoms point to more than one root.
• Dural repair ? if the dura is inadvertently opened, it is repaired at the same sitting, sometimes with a patch or sealant.
• Instrumented fusion ? reserved for demonstrated instability, usually in revision cases, and only after discussion.

Phase-by-Phase Recovery Timeline

These are typical ranges, not promises. Your surgeon's advice for your specific case takes priority.

Criteria for Returning to Work, Driving and Sport

Time alone is a poor guide. We use functional milestones.

• Driving a car: when you are off sedating painkillers, can turn your head and body to check blind spots without pain, and can perform an emergency stop. Usually two to three weeks.
• Two-wheeler riding: deferred longer ? commonly six to eight weeks ? because of road vibration and jolts, especially on uneven district roads.
• Desk or teaching work: two to four weeks, provided you can stand and stretch every 30 minutes.
• Manual labour, farming, construction, driving as a profession: commonly eight to twelve weeks, with graded return and lifting technique training.
• Gym, running, cricket, badminton, kabaddi: no leg pain at rest or on activity, near-normal power in the affected muscles, single-leg squat control, and clearance from your surgeon and physiotherapist. Contact and pivoting sport usually from around three months.
• Yoga: permitted, but forward-bending postures such as paschimottanasana and heavy spinal flexion are introduced last and under supervision.

Preventing Recurrence

Recurrent herniation at the same level occurs in roughly 5?15% of patients over several years. Some risk factors cannot be changed, but several can.

• Maintain a lifelong core and hip strengthening routine ? this is the single most useful measure.
• Lift with the hips and knees, keep the load close to the body, and never lift while twisting. Ask for help with water cans, gas cylinders and sacks of grain or cement.
• Break up sitting. Long stretches of desk work, or long-distance bus and train travel, load the disc; stand and walk every 30?40 minutes.
• Reduce habitual deep squatting and prolonged cross-legged floor sitting in the first three months. Long term, both are usually acceptable if you have the hip and ankle flexibility to do them without rounding the lower back.
• If your home has an Indian-style toilet, consider a raised commode seat or a Western commode for the first six to eight weeks. A footstool and a firm grab bar help.
• Floor sleeping is not harmful in itself, but a thin mattress on the floor with a hard rise to standing is difficult early on. Use a firm bed at a comfortable height for the first couple of months, then return to your usual arrangement if it suits you.
• Stop smoking and all forms of chewed tobacco ? nicotine impairs disc nutrition and healing.
• Keep weight and blood sugar controlled; diabetes affects both nerve recovery and wound healing.

Children, Adolescents and Older Patients

Children and adolescents

Disc herniation is uncommon under 18 but does occur, often in young sportspeople, wrestlers and gymnasts, and sometimes in children carrying heavy school bags with existing structural predisposition. Adolescent discs tend to be tougher and less likely to sequestrate, and outcomes after microdiscectomy are generally good. Non-operative care is pursued more patiently in this group, and any associated bony abnormality such as a ring apophyseal fracture or spondylolisthesis is looked for on imaging. Parental counselling, school liaison and a sport-specific return plan are part of care.

Older adults

In patients over 60, the picture is often mixed disc herniation and degenerative canal or lateral recess stenosis, so the operation may need to include a small bony decompression. Additional considerations include osteoporosis assessment, cardiac and renal fitness for anaesthesia, review of blood thinners, delirium prevention, and fall risk at home. Age by itself is not a contraindication; a well-selected older patient with disabling leg pain often does very well, and endoscopic or local-anaesthetic approaches can be an advantage where general anaesthesia carries higher risk.

If You Choose Not to Have Surgery

Declining or postponing surgery is a legitimate choice in the absence of red flags, and we will continue to look after you.

• Many herniations reduce in size over months as the extruded material is resorbed, and symptoms settle correspondingly.
• Long-term follow-up studies of disc herniation show that surgical and non-surgical groups converge over one to two years, with surgery mainly delivering faster relief.
• Ongoing options include supervised physiotherapy, neuropathic pain medication, transforaminal injections, weight and diabetes control, and workplace adjustment.
• The risks of waiting are persistent pain, deconditioning, medication side effects, loss of earnings, and, less commonly, incomplete recovery of muscle power if weakness is left compressed for a prolonged period.
• You must return immediately if you develop bladder or bowel disturbance, saddle numbness, or worsening weakness. These change the plan from elective to emergency.

Factors That Change the Cost of Microdiscectomy

We do not publish a single figure, because the final bill depends on clinical and administrative variables. The table below explains what moves it. For an itemised estimate for your case, please speak to the front office or the billing and insurance desk at Apollo Hospitals Lucknow before admission.

Insurance, Cashless Treatment and TPA Process in India

Microdiscectomy is a recognised inpatient surgical procedure and is covered by most Indian health insurance policies, subject to the terms of your specific policy. The insurance desk at Apollo Hospitals Lucknow handles pre-authorisation and coordinates with third-party administrators.

• Cashless route: for planned surgery, submit your policy or e-card and the surgeon's advice note at least three to five working days before admission. The hospital sends a pre-authorisation request to the insurer or TPA, who issue an approval letter specifying the sanctioned amount.
• Reimbursement route: if your insurer is not empanelled, you settle the bill and claim afterwards. Keep the discharge summary, itemised bill, payment receipts, investigation reports and implant stickers if any.
• Waiting periods: most indemnity policies apply an initial waiting period of about 30 days for illness, and a specified-disease or named-ailment waiting period ? commonly 24 to 48 months ? that can include spinal disc disorders and slipped disc surgery. Pre-existing disease waiting periods of two to four years may also apply. Check the exact clause in your policy wording before assuming cover.
• Accident versus planned cover: disc herniation following a documented road traffic accident or fall is usually treated as an accidental injury and is often payable from day one, bypassing named-ailment waiting periods. Degenerative herniation with no injury is treated as illness and is subject to the waiting periods above. Keep the FIR, accident report or emergency records if trauma is involved.
• Day-care clause: if your surgery is completed without an overnight stay, ensure your policy covers day-care procedures ? most modern policies do, but some older ones require a 24-hour hospitalisation.
• Room-rent capping and co-payment: choosing a room above your eligible category can proportionately reduce the payable amount on the entire bill. Senior citizen policies often carry a co-payment percentage.
• Government and employer schemes: Ayushman Bharat PM-JAY, CGHS, ECHS, state government schemes and corporate panels have their own package rates, referral requirements and documentation. Empanelment status and applicable packages should be confirmed with the insurance desk, as these change from time to time.
• Non-medical expenses: items such as attendant meals, registration and certain consumables are typically excluded and payable by the patient.

Planning Your Admission and What to Bring

• All imaging ? MRI and CT films or CDs, and previous X-rays ? plus any earlier spine surgery records.
• All prescriptions and a written list of current medicines with doses, including insulin, blood thinners and inhalers.
• Original photo ID (Aadhaar or similar) for you and your attendant, insurance card or policy copy, and the TPA approval letter if already issued.
• Loose, front-opening clothing, non-slip slippers, and a light shawl or blanket.
• Toiletries, spectacles, denture case, mobile charger and a long charging cable.
• Recent reports of blood sugar, HbA1c, kidney function and any cardiac evaluation.
• Leave jewellery, valuables and large amounts of cash at home.
• One attendant is usually enough for a day-care or overnight stay. In joint families, decide in advance who will stay overnight and who will manage home duties ? a rotating roster of caregivers works better than everybody attending on day one.
• Before you leave home, arrange a firm bed at a comfortable height, a raised commode seat if you have an Indian-style toilet, and a chair with arms and a straight back for the sitting-room.
• Confirm fasting time, reporting time and admission counter location with the hospital the day before.

Warning Signs That Need Urgent Review

Contact the hospital immediately, or attend the emergency department, if after surgery you develop:

• Difficulty passing urine, urinary or faecal incontinence, or numbness around the genitals, buttocks or inner thighs.
• New or worsening weakness in a leg or foot, or a foot that begins to drag.
• Fever with chills, or a wound that becomes red, swollen, hot, or discharges pus.
• Clear watery fluid leaking from the wound, or a severe headache that worsens on sitting up.
• Severe leg pain returning suddenly after an initially good recovery.
• Calf pain, swelling or tenderness, or breathlessness and chest pain, which may indicate a clot.
• Persistent vomiting, inability to take fluids, or blood sugar that is difficult to control at home.

For Patients Travelling from Outside Lucknow

Apollo Hospitals Lucknow receives spine patients from across central and eastern Uttar Pradesh and neighbouring states ? including Kanpur, Unnao, Rae Bareli, Barabanki, Sitapur, Hardoi, Lakhimpur Kheri, Bahraich, Gonda, Faizabad?Ayodhya, Sultanpur, Amethi, Pratapgarh, Jaunpur, Varanasi, Prayagraj, Gorakhpur, Basti, Shahjahanpur, Bareilly and Jhansi, and from parts of Bihar, Nepal border districts, Uttarakhand and Madhya Pradesh.

• Send imaging ahead. Share your MRI report and films digitally before travelling so an opinion on likely candidacy can be given and repeat tests avoided.
• Try to compress visits. Consultation, investigations and anaesthetic review can often be arranged over one or two days. Ask for this when booking.
• Travel comfort matters. If you have severe sciatica, prefer a train sleeper berth or a car where you can recline and stop every hour, rather than a long bus journey.
• Plan the return journey. Avoid travelling more than two to three hours by road within the first week. Where the journey is long, staying locally for four to seven days after discharge is more comfortable and safer.
• Accommodation. Guest houses, lodges and serviced apartments are available around the hospital area in Lucknow; the front office can point you to options, but bookings are made by you directly.
• Local follow-up. Ask for a clear discharge summary with medication list, wound care instructions and a written