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Systematic review
People with lumbar disc herniation and associated radiculopathy benefit more from microdiscectomy than advice in the short term, although there is no difference in the long term
  1. Scott D Daffner
  1. West Virginia University School of Medicine, Department of Orthopedics, Morgantown, West Virginia, USA
  1. Correspondence to Scott D Daffner
    3400 Health Sciences Center – 9196, Department of Orthopedics, Morgantown, WV 26508-9196, USA; sdaffner{at}hsc.wvu.edu

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Context

Lumbar intervertebral disc herniation with radiculopathy (LDHR) is one of the most common clinical entities seen by spine practitioners. Good clinical outcomes have been reported for both surgical and non-operative treatment of lumbar disc herniation with radiculopathy. In the absence of cauda equina syndrome, initial treatment is non-operative, with approximately 50–60% of patients reporting satisfactory symptomatic improvement after conservative care.1 2 Costs associated with treatment (surgical or conservative) can be high.3 Surgery and injections, as invasive procedures, carry with them a significant risk profile. Moreover, injections are the primary driver of non-operative treatment-related costs.3 In an era of cost-containment, effective, cost-efficient treatments must be prioritised. It is into this milieu that Hahne and colleagues venture with the present study. The goal of the current study was to determine the clinical efficacy and associated complications of conservative (non-invasive) treatment of patients with radicular symptoms clearly documented to be secondary to lumbar disc herniation.

Methods

The authors conducted a systematic review of English-language literature …

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