Malmivaara A, Westman R, Haverinen R, Ristikartanp V, Koivisto J; Health Technology Assessment International. Meeting (3rd : 2006 : Adelaide, S. Aust.).
Handb Health Technol Assess. 2006; 3: 17.
STAKES/FinOHTA, P.O. Box 220, Helsinki, Finland, FI-00531
Aim: To assess the long term results of effectiveness of surgical discectomy for lumbar disc herniation. Methods: A randomized controlled trial comparing microdiscectomy with continued conservative therapy in 20-50 -year-old patients with sciatica of 6-12 weeks' duration. Patients had clinical findings of nerve root compression and radiologically confirmed lumbar disc herniation. Fifty-six patients were randomised. All 28 patients in the microdiscectomy group underwent surgery, and eleven patients in the conservative group eventually crossed over to surgery because of pain or progressive neurological deficit. After a mean follow-up of six years (range 5 to 8 years) the intensity of leg pain (primary outcome), back pain and disability due to back pain were assessed with a questionnaire. Results: Fifty-one patients responded (91 per cent). Surgical patients reported significantly less leg pain and less disability [Table: see text]. Conclusions: Six-year outcomes showed less pain and disability in the surgical group, contrary to the only previous trial executed in the beginning of 70's. The way of treating back pain has evolved considerably in thirty years, and the new trial may have implications for current practice.
Publication Types:
Keywords:
- Back Pain
- Clinical Trials as Topic
- Decompression, Surgical
- Diskectomy
- Hernia
- Humans
- Intervertebral Disk
- Intervertebral Disk Displacement
- Laminectomy
- Lumbar Vertebrae
- Microsurgery
- Pain
- Pain Measurement
- Radiculopathy
- Research Design
- Sacrum
- Sciatica
- Spinal Fusion
- surgery
- hsrmtgs
UI: 103724783
From Meeting Abstracts