Efficacy of conservative treatment of lumbar disc herniation.
METHODS
This study comprises a total of 322 patients who were seen in our neurosurgical department as inpatients (N = 241) or outpatients (N = 81) for lumbar disk herniation. Patients presenting with major neurological deficits and/or symptoms reflecting lumbar stenosis were excluded. All patients were scheduled for conservative treatment which was based on bedrest for a minimum of two weeks. Thereafter, patients were assigned for further nonoperative or operative treatment.


RESULTS
According to our results only 49% of conservatively treated patients had to be operated on. At long-term follow-up with a mean observation time of 2 years as available in 125 patients, 93% of patients who did not undergo surgery were improved with respect to pain. Motor function had recovered in 60%, and sensory deficits in 58% of these cases.


CONCLUSIONS
In conclusion, conservative treatment is effective and in our opinion mandatory in the setting of sciatica caused by lumbar disc herniation except for patients presenting with severe, or progressive neurological deficits.
Zentner
J
J
Department of Neurosurgery, University of Bonn, Germany.
Schneider
B
B
Schramm
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D001510:Bed Rest; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D016896:Treatment Outcome