A discectomy is a surgical procedure in which the central portion of an intervertebral disc,the nucleus pulposus, which is causing pain by stressing the spinal cord or radiating nerves, is removed. Advances in options have produced effective alternatives to traditional discectomy procedures, i.e. microdiscectomy A laminectomy is often involved to permit access to the intervertebral disc in a traditional discectomy.

Minimally invasive surgical procedures avoid open invasive surgery in favor of closed or local surgery with less trauma. These procedures involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device, and are carried out through the skin or through a body cavity or anatomical opening. This may result in shorter hospital stays, or allow outpatient treatment.NCBI, National Center for Biotechnology Information, NCBI, MeSH, Medical SubHeadings, NLM, National Library of Medicine However, the safety and effectiveness of each procedure must be demonstrated with randomized controlled trials. The term was coined by John EA Wickham in 1984, who wrote of it in British Medical Journal in 1987.

Back pain (also known "dorsalgia") is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.

The pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may be felt in the neck (and might radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling.

Back pain is one of humanity's most frequent complaints. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.A.T. Patel, A.A. Ogle. "Diagnosis and Management of Acute Low Back Pain". American Academy of Family Physicians. Retrieved March 12, 2007.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities.

A spinal disc herniation, incorrectly called a "slipped disc", is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. This tear in the disc ring may result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of nerve root compression (see "chemical radiculitis" below). This is the rationale for the use of anti-inflammatory treatments for pain associated with disc herniation, protrusion, bulge, or disc tear.

It is normally a further development of a previously existing disc protrusion, a condition in which the outermost layers of the annulus fibrosus are still intact, but can bulge when the disc is under pressure.

Low back pain is a common musculoskeletal disorder causing back pain in the lumbar vertebrae. It can be either acute, subacute or chronic in its clinical presentation. Typically, the symptoms of low back pain do show significant improvement within two to three months from its onset. In a significant number of individuals, low back pain tends to be recurrent in nature with a waxing and waning quality to it. In a small proportion of sufferers this condition can become chronic. Population studies show that back pain affects most adults at some stage in their life and accounts for more sick leave and disability than any other single medical condition.

An acute lower back injury may be caused by a traumatic event, like a car accident or a fall. It occurs suddenly and its victims will usually be able to pinpoint exactly when it happened. In acute cases, the structures damaged will more than likely be soft tissue like muscles, ligaments and tendons. With a serious accident or due to osteoporosis or other causes of weakened vertebral bones, vertebral fractures in the lumbar spine may also occur. At the lowest end of the spine, some patients may have tailbone pain (also called coccyx pain or coccydynia). Others may have pain from their sacroiliac joint at the bottom of the lumbar spine, called sacroiliac joint dysfunction (see sacroiliac joint for more information). Chronic lower back pain usually has a more insidious onset, occurring over a long period of time. Physical causes may include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae, or a spinal disc herniation, a vertebral fracture (such as from osteoporosis), or rarely, a tumor (including cancer) or infection. The cause may also be psychological or emotional or due to other non-anatomical factors.

The sciatic nerve (also known as the ischiatic nerve) is a large nerve that starts in the lower back and runs through the buttock and down the lower limb. It is the longest and widest single nerve in the body.

The sciatic supplies nearly the whole of the skin of the leg, the muscles of the back of the thigh, and those of the leg and foot.

A world-renowned pioneer in the application of laser-assisted arthroscopic surgery, Dr. Alfred O. Bonati is the Chairman and Chief Orthopedic Surgeon at The Bonati Institute which he owns and operates. Dr. Bonati is a graduate of the University of Seville and the Bowman Gray Medical School, and completed internships and residencies at Cook County Hospital in Chicago, the University of Alabama, and Georgetown University.