From JAMA Vol. 296, No. 20, pp. 2451-2459, November 2006
Surgical vs Nonoperative Treatment
for Lumbar Disk Herniation
...In the group initially choosing nonoperative treatment, 2% underwent surgery in the first 6 weeks; while 16% had surgery by 6 months, and 22% had surgery by 2 years...
...The median surgical time was 70 minutes (interquartile range, 15-333 minutes) with an median blood loss of 50 mL (interquartile range, 0-1500 mL). Only 2 patients required transfusions. There were no perioperative mortalities. The most common surgical complication was dural tear in 2% of cases. Reoperation occurred in 7% of cases by 1 year and in 9% of cases at 2 years; more than half were recurrent herniations at the same level...
Conclusions Patients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care...
...The median surgical time was 70 minutes (interquartile range, 15-333 minutes) with an median blood loss of 50 mL (interquartile range, 0-1500 mL). Only 2 patients required transfusions. There were no perioperative mortalities. The most common surgical complication was dural tear in 2% of cases. Reoperation occurred in 7% of cases by 1 year and in 9% of cases at 2 years; more than half were recurrent herniations at the same level...
Conclusions Patients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care...
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