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In the few large trials in which researchers have compared surgical and nonsurgical management of sciatica caused by disk herniation, most participants had symptoms for less than 3 months. In those studies, pain relief at 1 year was similar in surgical and nonsurgical groups. In this new randomized trial from a single Canadian center, 128 patients with longer-duration sciatica (4–12 months) underwent either microdiskectomy or conservative care (consisting of physical therapy, plus epidural steroid injections in some cases). All patients had nerve-root compression at the L4–L5 or L5–S1 level on magnetic resonance imaging, and none had epidural injections or physical therapy prior to enrollment. Microdiskectomies were performed by a fellowshi…