Minimally invasive disc surgery. Nucleotomy versus fragmentectomy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• The optimal surgical management for herniated discs causing sciatica is a subject of ongoing clinical debate.
• Conventional microdiscectomy, central disc decompression, nucleotomy, arthroscopic lumbar microdiscectomy, and fragmentectomy are among the discussed surgical techniques.

Purpose of the Study:

• To present contrasting viewpoints on the most effective surgical interventions for herniated discs with sciatica.
• To evaluate the safety and efficacy of central disc decompression versus arthroscopically assisted fragmentectomy.

Main Methods:

• Presentation of expert opinions and surgical approaches for herniated disc treatment.
• Discussion of minimally invasive techniques including central disc decompression and arthroscopic fragmentectomy.

Main Results:

• Dr. Gary Onik advocates for central disc decompression, citing its safety and efficacy, particularly for recurrent disc herniations.
• Dr. Parvis Kambin supports arthroscopically assisted fragmentectomy as the preferred surgical choice.

Conclusions:

• Both central disc decompression and arthroscopically assisted fragmentectomy are presented as viable minimally invasive surgical options for sciatica due to herniated discs.
• The choice of procedure may depend on specific clinical factors, such as recurrent herniations.