Does a herniated lumbar disk with nerve root entrapment require surgical intervention: Are alternative treatments as effective?

Abstract

The usefulness of surgery versus nonoperative measures in managing the patient with a herniated lumbar disk presenting with sciatica is somewhat controversial. Although most patients improve with nonoperative measures and time, some continue to have symptoms that impact on their ability to work and perform daily activities. Lumbar diskectomy, although widely used, remains problematic for surgeons due to uncertainties regarding its risks, benefits, indications, and optimal technique.The purpose of this article is to assess the outcome of conventional diskectomy techniques and compare them with nonoperative therapies.