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In 2007, Dutch researchers reported the results of a trial that compared early surgery versus conservative management (e.g., analgesics, physiotherapy) for sciatica of 6- to 12-weeks duration that was secondary to a herniated lumbar disk. Patients improved more quickly with surgery than with conservative management; however, no differences in disability, back pain, and leg pain were noted between the groups after 1 year (JW May 30 2007). The same researchers now report follow-up data after 2 years.
Of the 141 patients originally randomized to early microdiskectomy (within 2 weeks of randomization), 89% underwent the procedure (11% spontaneously recovered). Of the 142 randomized to conservative management, 44% crossed over to surgery (5% did …