Lumbar Herniated Disc/Sciatica – Microendoscopic Discectomy Versus Open Surgery Versus Prolonged Conservative Treatment

Wayne R. Nelson, DC ConditionForLife.net November 9, 2015 Lumbar-spine disorders rank fifth among disease categories in the cost of hospital care and account for higher costs resulting from absenteeism from work and disability than any other category. The natural history of sciatica is favorable, with resolution of leg pain within 8 weeks from onset in the majority of patients. Although relief of symptoms was twice as fast among patients with sciatica who were treated with early surgery as among those who were treated conservatively, this multicenter, randomized trial demonstrated that this strategy did not result in a better overall 1-year functional recovery rate than did a policy of prolonged conservative treatment with an offer of subsequent surgery. The benefits of surgery for speed of recovery and relief of pain were consistent among patients in all predefined subgroups, except for patients whose sciatica was not provoked by sitting.