Surgery better for herniated discs: study
Suffering from herniated disc? Go for surgery if you are seeking long-term improvements.
"Surgery leads to greater long-term improvement in pain, functioning and disability compared to non-surgical treatment," said Dr. Jon D. Lurie of Dartmouth-Hitchcock Medical Centre and Geisel School of Medicine and colleagues.
For patients with herniated discs in the lower (lumbar) spine, surgery is a better option than non-invasive treatment, says the new study.
The results add to the evidence for surgical treatment of herniated discs-but also show that non-surgical treatment can provide lasting benefits for some patients, said the study published in the journal Spine.
The researchers analysed data from the Spine Patient Outcomes Research Trial (SPORT), one of the largest clinical trials of surgery for spinal disorders.
In SPORT, patients suffering from herniated discs in the lumbar spine underwent surgery or non-surgical treatment such as physical therapy, exercise and pain-relieving medications.
The researchers did a eight-year follow-up exercise on 1,244 patients treated at 13 spine clinics across the US.
About 500 patients were randomly assigned to surgery (a procedure called discectomy) or non-surgical treatment, although patients were allowed to "cross over" to the other treatment, said the study.
For the remaining patients, decisions as to surgery or non-surgical treatment were left up to the patients and their doctors.
They found patients assigned to surgery tended to have better outcomes. When outcomes were compared for patients who actually underwent surgery versus non-surgical treatment, significant differences emerged.
While average outcome scores were better with surgery, many patients had significant improvement with non-surgical treatment. After eight years, about one-third of patients who were clinically indicated for surgery have chosen not to have operative treatment.
Past studies have suggested that surgery provides faster pain relief and recovery for patients with herniated discs, compared to non-surgical treatment. However, it has been difficult to determine the true effects of surgery -e specially because of the high number of patients who cross over from non-surgical treatment to surgery.
Patients with herniated discs experience back pain, leg pain (sciatica) and other symptoms caused by pressure on the spinal nerve roots.
(Posted on 28-12-2013)