Examination of nonoperative treatment of lumbar disc herniation

Abstract

The aim of this study is to determine the optimal periods for conservative therapy of lumbar disc herniation and when it is appropriate to implement surgical intervention. From 1991 through 1996, after a diagnosis of lumbar disc herniation was made, we recommended surgical treatment at an early stage for the patient who did not obtain good results via conservative treatment (group 1), from January 1997 forward, prolonged conservative treatment was extended from two to four weeks (group 2). By comparison the number of patients in group 2 who were operated decreased significantly when compared with patients in group 1 who underwent surgery. We concluded that extended conservative treatment significanly reduced the incidents of surgical intervention in group 2. Although, the exact mechanism is unknown, it is thought that resolution of herniated nuclear material occurs upon contact with the epidural space in the extrusion type. Because the number of operation performed within one month was remarkably decreased in the group 2, we concluded that optimal period of the conservative therapy is one month.