Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review

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5 randomized controlled trials consisting of 1135 patients with sciatica caused by lumbar disc herniation were evaluated to determine the impact of early surgery versus conservative treatment (prolonged conservative treatment, usual conservative treatment, or epidural injections) on pain, function, and recovery. Results indicated that patients who underwent surgical treatment experienced reduced pain and faster recovery in the short-term compared to those who received conservative therapy or epidural steroid injections. However, no significant differences in clinical outcomes were seen between the two types of treatment in the long-term.