[The role of surgery in the treatment of sciatica. An experience of more than 4000 operations].

Sciatica must always be first considered as a medical problem. Operation is indicated only for refractory cases. Analysis of more than 4 036 operations shows the best indications for surgery. These consist of typical disc sciatica, sciatica with excessive pain, with paralysis and with cauda equina syndrome. Myeloradiculography was not carried out routinely, being reserved for atypical forms. A negative radiculography is not necessarily a contraindication. The results of foraminotomy are less constant than after removal of a disc prolapse. It benefits 60 p. cent of patients, however. Some reserve applies to its use since it is not possible to predict those patients who will be relieved. There exist finally those cases in which the organic origin of the pain cannot be proved, at which time the surgeon should refuse operation which may be an aggravating factor.