Disc Herniation (Primary, Recurrent, Residual)

Lumbar disc herniation (LDH) is a frequent cause of radiculopathy. The underlying surgical principle is to alleviate nerve root compression triggered by the herniation. Understanding the optimal surgical approach for nerve root decompression and resection of the disc fragment is imperative. Existing treatment options vary and are largely dependent on surgeon preference. The use of magnification and illumination systems by microscope and endoscope have advanced minimally invasive approaches. Existing literature has demonstrated that all approaches seem to provide clinical outcomes of similar quality. Nonetheless, the optimal surgical approach is guided by the radiological and clinical findings and will address the underlying pathology to provide satisfactory clinical results. In this chapter, we focus on the treatment of LDH, including primary, recurrent, and residual LDH.