In the 22 November issue of the Journal of the American Medical Association, a study was published following people for two years who were treated with or without surgery for herniated lumbar discs.

This was a large trial conducted between March 2000 and November 2004 enrolling over 500 surgical candidates from 13 different spine clinics in 11 US states. They were randomised to open discectomy versus individualised conservative non-operative treatment. All had confirmed disc herniation and persisting signs and symptoms of radiculopathy for more than six weeks. They looked at various pain and function end-points.

Based on their analysis there was no significant difference between the groups in the major end points. Both groups whether treated surgically or otherwise, improved substantially over the two year period.

Comments:
It seems that surgery for lumbar disc prolapse is becoming much less common and it seems reasonable to consider conservative treatment in the long term, even with patients with significant symptoms and radiculopathy. Patients should talk to their doctors about the options regarding surgery and conservative care. We will provide further updates on this type of research through our newsletter.

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