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These two studies address the use of surgery for different types of degenerative lumbar spine disease.
Peul and colleagues randomized 283 patients with lumbosacral radicular pain to either microdiskectomy or conservative treatment; incapacitating lumbosacral radicular pain had lasted 6 to 12 weeks and was due to lumbar disc herniation. In the conservative-treatment group, surgery was offered after 6 months to patients with persistent sciatica and before 6 months to patients with nonresponsive leg pain or progressive neurologic deficits.
Of the 141 patients randomized to early surgery, 16 recovered before surgery could be performed; the remainder underwent surgery with a median delay of 1.9 weeks. Of 142 patients randomized to conservative tre…