Sciatica caused by vertebral disc herniation: Early surgery versus conservative care
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2007 May 31;356(22):2245-56 Randomized Controlled Trial
IN vertebral disc herniation, sciatica, persistent The Use of
systematic early lumbar disk (microdiskectomy) surgery
As Treatment, Acute
Is equal Than
prolonged conservative treatment with surgery later if needed
To achieve perceived recovery at 1 year: 95% both groups. Early surgery patients had a faster perceived recovery
BMJ. 2008 Jun 14;336(7657):1355-8 Randomized Controlled Trial, Multicenter Study
IN vertebral disc herniation, sciatica, persistent The Use of
systematic early surgery (removal of disc herniation)
As Treatment, Acute
Is equal Than
maintaining conservative treatment, with surgery later if needed
To improve long-term (at 2 years) disability and leg and low back pain, despite initial (at 3 months) larger reductions in disability and pain with surgery.