Sciatica--management by chemonucleolysis versus surgical discectomy.

Two therapeutic approaches designed specifically to relieve the symptoms of sciatica and resolve the signs of lumbar radiculopathy brought about by herniation of the nucleus pulposus have evolved. The surgical removal of the lumbar disc is an operation which has undergone miniaturization in recent years. Treatment of disc hernia by chemical hydrolysis of the nucleus pulposus (chemonucleolysis) has, over the past 20 years, become an alternative to open surgical treatment. These two forms of therapy are compared as to their efficacy and safety. Neurosurgeons now have the data to decide on the suitability of employing one or the other (or both) of these forms of treatment in the care of patients with intractable sciatica.