One hundred twenty-eight patients with sciatica lasting 4 to 12 months due to lumbar disc herniation were randomized to receive either microdiscectomy (n=64) or 6 months of standardized nonoperative care (n=64). The primary outcome was leg pain intensity at 6 months. Secondary outcomes included back pain, Oswestry Disability Index (ODI), SF-36 quality-of-life scores, employment status, and treatment satisfaction, assessed at multiple time points up to 12 months. Overall, the results of the study revealed that microdiscectomy led to a significantly greater reduction in leg pain at 6 months and consistent improvements in secondary outcomes. These findings suggest that surgery is more effective than prolonged conservative care in managing persistent sciatica beyond 4 months.