Table 1.
Prospective, randomized, controlled trials regarding treatment of lumbar disc herniation
| Study | Treatments | Results | Follow-up Duration | Percent patient crossover |
|---|---|---|---|---|
| Weber et al18 | Surgery versus nonoperative management | Significantly better results for surgical patients after one year | Ten years | 35% C 2% S |
| Buttermann et al6 | Surgery versus epidural steroid injection | Better results for surgical patients. No statistically significant advantage for surgery |
Two to three years | 54% C 0% S |
| Osterman et al13 | Surgery versus conservative management | No clinically significant differences between surgery and nonoperative management | Two years | 39% C 0% S |
| Weinstein et al19 | Surgery versus NSAIDs, physical therapy, and individually tailored conservative management | No clinically or statistically significant differences between surgery and nonoperative treatment | Two years | 45% C 40% S |
| Peul et al14,15 | Surgery versus pain control and physical therapy | Early significant benefit for surgical patients in regard to relief of leg pain. No difference between groups after six months |
One and two years | 39% C14 11% S14 44% C15 11% S15 |
Key: C, Patients randomized to conservative management cross over to surgical group; S, patients randomized to surgery cross over to conservative management group.