I agree with doing the least invasive surgery that has a good chance of addressing your pain with caveat... the disc must be in good enough shape to have a chance to survive. I've seen way too many people who've had discectomies/laminotomies done on discs that were so very severely compromised that there was no real chance. Symptoms go away for a few months, but as the disc collapses further, the symptoms come back or new symptoms (other sided leg pain?) appear.
If they evacuate the disc space, you stand an increased risk of further collapse, faster.
If they don't evacuate the disc space, you stand an increased risk of recurrant herniation. (Not evacuating the disc space is considered to be old school by many of the doctors I know, but they concede the trade-off.)
I would still choose less invasive if I'm a good candidate. Doing less invasive when the disc is so severely compromised can be more wishful thinking than an effective approach. You only get so many times to cut before the laws of diminishing returns catch up with you.
Mark
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