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Microdiskectomy
7%
227/3385
Posterior spinal fusion with instrumentation
0%
16/3385
Decompression only
2%
78/3385
Strict bedrest
1%
23/3385
Anti-inflammatory medication and physical therapy
89%
3014/3385
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Lumbar disc herniation is the most common cause of radicular pain in the adult working population. 95% of these herniations involve L4/5, L5/S1 lumbar disc spaces. Patients typically present with low back pain and sharp stabbing leg pain with sensory symptoms in a specific dermatomal distribution. Persistent intractable pain following non-surgical treatment during a minimum 6 week period is the most frequent indication for surgery. The Weber article was a RCT over 10 yrs of 126 pt with sciatica due to herniated lumbar discs. The results of surgical treatment were significantly better than the results in the conservatively treated group after one year of observation, however this difference became much less pronounced after nine more years. Saal et al retrospectively reviewed 11 patients treated nonoperatively with lumbar disc extrusions through CT/MRI to evaluate disc morphology initially and at follow up (mean 25 mos). Only 1 patient had progression of stenosis, and all patients had disc dessication at the level of disc herniation with contiguous levels being normally hydrated. All patients had a decrease in neural impingement.
3.7
(31)
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