Surgical treatment may be suggested to treat pain that has not responded to non-operative treatment or if there is severe neurologic deficit such as bowel or bladder incontinence or progressive weakness in vital muscle groups. With the exception of the presence of severe neurologic deficits, the decision to proceed with surgery is a quality of life decision. Surgical options for a lumbar disc herniation are listed below. These surgical options often include a combination of surgical treatments (i.e. decompression, fusion, instrumentation). 1. Lumbar Laminotomy/Foraminotomy: This procedure is used to remove part of the lamina and overgrown facet joint to relieve unilateral leg symptoms and is usually performed with the aid of magnification (either surgical loupes or microscope). Lumbar laminotomy/foraminotomy is the most commonly performed procedure for a standard posterolateral disc herniation. 2. Minimally Invasive Procedures: Posterior foraminotomy can be performed through tubes and with the use of endoscopes. Laser decompression and disc removal have also been performed with mixed results. 3. Far Lateral Discectomy: If the disc herniation occurs far lateral (occurs in approximately 10% of all disc herniations), this procedure is often necessary to relieve the pressure on the exiting nerve root. 4. Lumbar Laminectomy/Foraminotomy: With this procedure, the lamina and overgrown facet joints are removed to make room for the nerves.