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Well, I've tried everything to get rid of my sciatica -- and I mean everything. Massage, acupuncture, stretching, exercise, yoga, and more. I even quit smoking and tried hypnosis. Nothing worked. I'm ready to have the doc just cut the herniated disc out. What does this kind of surgery involve?

Depending on what's been done already, your surgeon may order a couple more tests before proceeding with surgery. MRI of your lumbar spine may be one of those tests. Discography may be another. Discography is used to see if the disk is the true source of your pain.

With discography, a dye is injected into the disc. Increased pain occurs because of increased pressure within the disc. If there are any cracks, fissures, or openings in the outer covering of the disc, the dye will ooze or seep out into the epidural space.

The surgeon uses a special X-ray machine called a fluoroscope to guide the procedure and see if the dye moves out of the disc. If surgery is indeed indicated for you, then there are several options to choose from.

The standard operation is an open discectomy. The surgeon makes an incision through the back of your spine and removes any disc fragments or even the entire disc. Less invasive methods such as chemonucleolysis, laser discectomy, electrothermal therapy, and percutaneous nucleoplasty are possibilities.

Once you see a surgeon and find out if you are a good candidate for discectomy, he or she will discuss what options are the best for you.

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