Evidence Limited for Long-Term Benefits of Discectomy for Sciatica

THURSDAY, April 20, 2023 (HealthDay News) -- The benefits of discectomy for sciatica diminish over time, eventually yielding similar results to those of nonsurgical management, according to a systematic review and meta-analysis published online April 20 in The BMJ.

Chang Liu, M.D., from the University of Sydney in Australia, and colleagues conducted a systematic literature review to identify studies evaluating the effectiveness and safety of surgery versus nonsurgical treatment for sciatica.

Based on 24 included studies, the researchers found that for discectomy versus nonsurgical treatment, there was very low- to low-certainty evidence showing a reduction in leg pain. At immediate term and short term, the effect size was moderate but was small at medium term and negligible at long term. Small, negligible, or no effects were found for disability. The risk for any adverse event was comparable for discectomy versus nonsurgical treatment (risk ratio, 1.34; 95 percent confidence interval, 0.91 to 1.98). Effects were similar for discectomy versus epidural steroid injections, with a moderate effect on disability at short term, but no effect was observed at medium and long term.

"Discectomy might be an option for people with sciatica who feel that the rapid relief offered by discectomy outweighs the risks and costs associated with surgery," the authors write.

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