Operations in spinal surgery are not always needed. Do we operate more than we should?

Area of Science:

• Orthopedics
• Neurosurgery
• Rehabilitation Medicine

Background:

• Lumbar disc herniation and low back pain are leading causes of disability.
• Surgical decisions for these conditions are often made readily, incurring significant healthcare costs.
• The effectiveness and patient satisfaction following surgical intervention require thorough evaluation.

Purpose of the Study:

• To assess the sufficiency of conservative treatment for lumbar disc herniation and low back pain.
• To determine patient satisfaction rates two years post-operation.
• To compare outcomes between conservative and surgical management strategies.

Main Methods:

• A study involving 127 patients with lumbar disc herniation (no neurological deficits).
• Patients were divided into conservative treatment (72) and microsurgical discectomy (55) groups.
• Outcomes were measured using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), SF-36, and EQ-5D.

Main Results:

• Both conservative and operative groups showed significant improvement in SF-36 and ODI scores (P<0.01).
• Two-year post-treatment results were comparable between groups for SF-36 and ODI.
• Improvements in back and leg pain (VAS) were significant in both groups (P<0.01), with no significant difference in return-to-work rates.

Conclusions:

• Operative treatment for lumbar disc herniation offers comparable outcomes to conservative management.
• Conservative treatment should be considered the primary approach due to economic advantages.
• Both methods effectively alleviate pain and improve function in patients with lumbar disc herniation.