[Role of surgical treatment of low back pain and lumbo-sciatica]

Low back pain alone without any sciatica is not an appropriate indication for lumbar disc surgery. The only exception might be a clinically and radiologically proven segmental instability. However a conservative multidisciplinary treatment should precede surgery. Good and excellent results of lumbar disc surgery are achieved in 80-90% of cases. The appropriate surgical indication and the postoperative reeducation are of utmost importance for good results. The patients history, neurological examination, neuroradiological imaging and failed conservative treatment modalities are key elements to define appropriate surgical candidates. Microdisectomy remains the "gold standard" for surgical treatment of lumbar disc disease assuring a better quality of life at long term follow up.