THERAPEUTICS
Early surgery was better than conservative care for short-term disability and pain in sciatica
| The first 150 words of the full text of this article appear below. |
W C Peul
Dr W C Peul, Leiden University Medical Centre, Leiden, The Netherlands; w.c.peul@lumc.nl
STUDY DESIGN
randomised controlled trial.
{concealed}*.
unblinded.
STUDY QUESTION
9 hospitals in the Netherlands.
283 patients 18–65 years of age (mean age 43 y, 66% men) who had 6–12 weeks of sciatica diagnosed by a neurologist, disc herniation with nerve root compression confirmed by magnetic resonance imaging, and pain distribution and neurological disturbances correlated to the same nerve root. Exclusion criteria included cauda-equina syndrome, severe paresis, same complaints within 12 months, and history of spinal surgery, spinal stenosis, deformity, or severe comorbidity.
early surgery (n = 141), which included removal of disc herniation using a unilateral transflaval approach and removal of loose degenerated disc material, or conservative care (n = 142) provided by family physicians, with consideration of surgery for increasing leg pain and neurological deficit (within 6 mo) or persistent sciatica (after 6 mo).
included functional disability (23-point
Griffith University, Logan City, Queensland, Australia
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Pain (neurology)
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