A variation called percutaneous automated discectomy uses a motorized probe that cuts off bits of disc material, but it does not appear to offer additional benefits. When using endoscopy, surgeons cannot observe the nerve root itself, so they cannot tell if the fragments removed are the source of the trouble, nor can they locate and remove any matter that has gone beyond the disc and entered the spinal canal. Endoscopy, then, is not usually warranted for herniated discs, a primary cause of sciatica. Some experts argue that these procedures are rarely useful and patients often need repeat operations. Lasers have been investigated for use with discectomy, but results to date are unimpressive.
Scar tissue is a significant problem, since it can cause persistent low back pain afterward.
Anti-scarring agents or certain devices may help reduce surgical scars and thereby postoperative pain. It may also be used to remove benign tumors on the spine. There are small risks to the operation and it is not always successful. Some recurrence of back pain and sciatica occurs in half to two-thirds of postoperative patients. One study reported that the operation in children and young adults can increase the risk for spinal deformity.