Diskectomy for Sciatica Might Provide Short-Term Relief of Pain and Disability

Most sciatica is caused by herniated lumbar disks; for most cases, nonsurgical management is recommended before considering surgery. To examine the evidence supporting surgery, researchers reviewed 24 randomized trials (with 1900 participants) in which any surgical treatment for sciatica due to herniated disk (i.e., diskectomy, percutaneous plasma disk decompression, or chemonucleolysis) was compared with any nonsurgical management (i.e., nonpharmacological, pharmacological, interventional, or placebo or sham surgery).

In 12 trials, diskectomy was compared with nonsurgical management; mean duration of symptoms was at least several months in most trials. Very low– to low-certainty evidence showed that diskectomy yielded moderate reduction in …