Surgical versus conservative treatment for lumbar disc herniation

Abstract

Objective: to compare the long term and short-term outcomes of conservative and surgical treatment of sciatica symptom severity and improving quality of life among patients diagnosed with lumbar disc herniation.

Methodology: Study was conducted at Neurosurgery department Gambat Institute of Medical Sciences, Gambat Pakistan from February 2022 to January 2023. Overall, 180 patients were included in this study. The patients randomly divided as surgical group whereas patients in control group. Patients eligible for inclusion in the study were those aged 18 or older, diagnosed with low-back pain symptoms caused by lumbar disc herniation accompanied by radicular pain and demonstrating signs of nerve root irritation. The severity of sciatica symptoms was evaluated using the NASS questionnaire and quality of life with the SF-36.

Results: According to NASS back pain, less pain was observed in surgical group than control group at 6 weeks, 12 weeks, 1 year and 2 years after treatment, p>0.050. Surgical group has more response to treatment than control group at 6 weeks after treatment, 63.4% and 37.1%, respectively, (p=0.005). Whereas, after 12 weeks, 1 year and 2 years, both the groups had almost equal response to treatment, (p>0.050). Further, it was noted that surgical group and control group were almost equal with respect to NASS neurogenic, NASS functions, SF-36 physical functions and SF-36 mental functions.

Conclusion: Surgical treatment for lumbar disc herniation offered quicker relief from back pain symptoms compared to conservative therapy, yet failed to demonstrate superior benefits over conservative approaches during midterm and long-term follow-up periods.