title: Minimally invasive disc surgery. Nucleotomy versus fragmentectomy.
abstract: There is continued debate as to the optimum surgical management of a herniated disc with sciatica. There are proponents of conventional microdiscectomy as well as those who advocate minimally invasive approaches, including central disc decompression or nucleotomy as well as arthroscopic lumbar microdiscectomy and fragmentectomy. In this controversy (I), Dr. Gary Onik takes the position that central disc decompression is both safe and efficacious and may be the procedure of choice for recurrent disc herniations (II). Dr. Parvis Kambin takes the opposing position and advocates arthroscopically assisted fragmentectomy as the procedure of choice.
authors.affiliation: Center for Diagnostic Imaging, Winter Park, Florida, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Onik
authors.forename: P
authors.initials: P
authors.lastname: Kambin
authors.forename: M K
authors.initials: MK
authors.lastname: Chang
mesh_terms: D017586:Diskectomy / Q000379:methods* / Q000592:standards; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D012585:Sciatica / Q000601:surgery*