Abstract
Conservative care of sciatica is effective in the majority of patients. When this therapy fails to relieve the patient's leg symptoms or when a progressive neurological deterioration occurs, surgery is the best alternative. Two key elements in the successful surgical management of sciatica are discussed in this review, patient selection and preoperative evaluation. Pathological variations in lumbar disc disease encompass these areas. The fact that lumbar disc displacement and subsequent lumbar nerve root compression occur in definite patterns aids in the preoperative evaluation and surgical care. It is the understanding of these pathological variations in symptomatic lumbar disc disease that make the surgery safer, more precise, and predictable. In addition to these variations or patterns, common pitfalls in lumbar disc disease are reviewed.
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