Care Plan          

Algorithm > 4 weeks - Neurologic Limb Symptoms? - Primarily Leg Pain?

Surgery is Performed

Standard discectomy and microdiscectomy are of similar efficacy and appropriate for selected patients with herniated discs and nerve root dysfunction.

Chymopapain is an acceptable treatment for such patients, but less efficacious than standard or microdiscectomy. If chymopapain is being considered, testing patients for allergic sensitivity to this substance can reduce incidence of anaphylaxis.

Percutaneous discectomy is significantly less efficacious than chymopapain.