Treatment of lumbar disc herniation: Evidence-based practice

Andrew J Schoenfeld, Bradley K Weiner, Andrew J Schoenfeld, Bradley K Weiner

Abstract

Clinical question: What is the best treatment for lumbar disc herniations?

Results: For patients failing six weeks of conservative care, the current literature supports surgical intervention or prolonged conservative management as appropriate treatment options for lumbar radiculopathy in the setting of disc herniation. Surgical intervention may result in more rapid relief of symptoms and restoration of function.

Implementation: While surgery appears to provide more rapid relief, many patients will gradually get better with continued nonoperative management; thus, patient education and active participation in decision-making is vital.

Keywords: back pain; herniation; lumbar disc; spine.

Figures

Figure 1.
Figure 1.
Sagittal magnetic resonance image of an L5/S1 disc herniation in the setting of degenerative disc disease. The patient was a 41-year-old woman with a six-week history of right-sided radicular leg pain in an S1 nerve root distribution. The patient failed conservative treatment, including physical therapy and pain management. Her symptoms were successfully relieved with a right-sided L5/S1 microdiscectomy.

References

Further reading

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    1. McCulloch JA, Edwards CC, II, Riew KD. Lumbar microdiscectomy. In: Bradford DS, Zdeblick TA, editors. Master Techniques in Orthopaedic Surgery: The Spine. Philadelphia, PA: Lippincott Williams & Wilkins; 2002.
References
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Source: PubMed

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