Is surgery necessary for a herniated disk?

By Geoff Michaels, May 1st, 2013 | Health | 0 Comments

Patients who have a herniated disk show same level of improvement with or without surgery.
Some patients with back and leg pain have a herniated lumbar disk. That is, one of the disks between the bones in the spine slips out of position. This can be seen on imaging but may not always give rise to symptoms. One treatment is to remove the offending disk - a procedure called lumbar diskectomy. In a study, researchers at Dartmouth Medical School have compared the outcomes of lumbar diskectomy with non-surgical treatment for a group of patients with diagnosed herniated lumbar disk.

In the trial, 232 patients had lumbar diskectomy and 240 had non-surgical treatment consisting of physical therapy, education and counseling, and medication. During two years of follow up, patients in both groups improved substantially. There was a small, but not significant, advantage for surgery, overall. When it came to sciatica severity and self-rated improvement, the advantage of surgery did become significant, however. It is difficult to make firm recommendations on these findings, because there was a high level of cross-over between the two groups. That is, some who originally intended to have surgery did not have it and some in the non-surgery group ended up having the operation after all. Further research into the best approach to herniated disk treatment is now warranted.