Sciatica from disk herniation: Medical treatment or surgery? - 27/12/07
Spine Section of the French Society for Rheumatology
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Abstract |
Disk-related sciatica is a common disorder that resolves without surgery in 95% of patients within 1 to 12months. Several treatment strategies designed to hasten recovery, enable a return to previous social and occupational activities, and prevent chronicization have been evaluated. Available efficacy data support the use of analgesics, nonsteroidal anti-inflammatory drugs, and epidural steroid injections, which probably relieve the pain and improve the quality of life without radically changing the midterm outcome. After a specialized evaluation of physical, psychological, social, and occupational factors, surgery may be offered to patients with persistent nerve root pain (as opposed to low back pain). The complication rate ranges from 1% to 3%. Surgery is clearly effective, shortening the time to recovery by about 50% compared to nonsurgical treatment. Whether one specific surgical procedure is better than others remains unclear. Methodological weaknesses of studies evaluating the efficacy of percutaneous methods preclude definitive conclusions. Bed rest, systemic glucocorticoid therapy, spinal manipulation, bracing, spinal traction, and physical therapy have no proven effects on the outcome of sciatica.
Le texte complet de cet article est disponible en PDF.Keywords : Sciatica, Treatment, Surgery, Healthcare network
Plan
Vol 74 - N° 6
P. 530-535 - décembre 2007 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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