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Surgery Not Necessarily Better for Lumbar Disc Herniation

Last Updated: February 04, 2010.

Both surgical and non-surgical treatments for lumbar disc herniation are effective, and the relative long-term benefits of surgery may differ depending on whether or not the patient has workers' compensation, according to a study in the Jan. 1 issue of Spine.

THURSDAY, Feb. 4 (HealthDay News) -- Both surgical and non-surgical treatments for lumbar disc herniation are effective, and the relative long-term benefits of surgery may differ depending on whether or not the patient has workers' compensation, according to a study in the Jan. 1 issue of Spine.

Steven J. Atlas, M.D., of Harvard Medical School in Boston, and colleagues conducted a study of 924 patients who had at least six weeks of sciatica and a lumbar intervertebral disc herniation, of whom 811 did not have workers' compensation and 113 did. After treatment with either surgery or non-operative care, the subjects were followed for two years.

Both groups of patients had major improvements in terms of pain, function and satisfaction, whether they had surgical or non-operative treatment, the researchers found. Among the patients without workers' compensation, the surgical option was advantageous at three months, and this persisted to the two-year mark; however, among those with workers' compensation, the advantages of surgery diminished over time and surgery showed no advantage at the two-year mark, the investigators note.

"Surgical treatment was not associated with better work or disability outcomes in either group," the authors write. "Physicians should discuss the risks and benefits of treatment options including surgery, and treatment decisions should be based on informed choice using a shared decision-making approach."

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