Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review

摘要: The effectiveness of surgery in patients with sciatica due to lumbar disc herniations is not without dispute. goal this study was assess the effects versus conservative therapy (including epidural injections) for herniation. A comprehensive search conducted MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up October 2009. Randomised controlled trials adults radicular pain, which evaluated at least one clinically relevant outcome measure (pain, functional status, perceived recovery, lost days work) were included. Two authors assessed risk bias according Cochrane criteria extracted data. In total, five studies identified, two a low bias. One compared early prolonged care followed by if needed; three usual care, injections. Data pooled because clinical heterogeneity poor reporting large low-risk-of-bias trial demonstrated that 6-12 weeks pain leads faster relief when treatment, but there no differences after 1 2 years. Another between found statistically significant on any primary measures Future should evaluate who benefits more from care.