Microdiscectomy/Lumbar Disc Herniation

Lumbar disc herniation

A Controlled, Prospective Study with Ten Years of Observation

Two hundred eighty patients with herniated lumbar discs, verified by radiculopathy, were divided into three groups. One group, which mainly will be dealt with in this paper, consisted of 126 patients with uncertain indication for surgical treatment, who had their therapy decided by randomization which permitted comparison between the results of surgical and conservative treatment. The controlled trial showed a statistically significant better result in the surgically treated group at the one-year follow-up examination. After four years the operated patients still showed better results, but the difference was no longer statistically significant.

The controlled study has shown that, with a follow-up of one year, surgery is more efficient than conservative therapy as treatment for low-back pain and sciatica caused by disc herniation.

A period of three months was sufficient to decide against surgery in four-fifths of the 60% conservatively treated patients with good and fair results. An observation time of this length may be advisable.

In a randomized series of 126 patients with sciatica due to a herniated lumbar discs with questionable operative indications, the results of surgical treatment were significantly better than the results in the conservatively treated group after one year of observation.

The natural course of radiculopathies in disc disease is more encouraging than expected.

1982 Volvo Award in Clinical Science
– Henrik Weber, MD Spine 1983;8:131-140