I find that majority of disc herniations respond to nerve blocks and therapy. Newer medication such as Lyrica may also help. In those patients that fail this treatment,a small incision removing very little bone is required to remove this disc material pressing on the Sciatic nerve. However, I also believe the primary issue is safety! Too much is being promoted by doctors about incision size rather then removing the full blockage. Many herneation have the disc tethered to nerve room and adequate exposure during surgery is a must. This may require a larger incision to see that all material that circles the nerve is fully removed without damage to the nerve.in my exoerice patients are most satisfied when their leg pain is gone 80 percent after surgery.