Who is a good candidate for PELD, and who should avoid it?

Good candidates include patients with symptomatic lumbar disc herniation causing leg pain (sciatica), numbness, or weakness that has not improved with conservative treatment for 6–12 weeks. Contraindications include severe spinal instability, advanced degenerative changes, spinal infections, tumors, or significant central canal stenosis. A thorough preoperative evaluation is essential.