Efficacy of conservative treatment of lumbar disc herniation.

MATERIALS AND METHODS: This study comprises a total of 322 patients who were seen in our neurosurgical department as inpatients (N = 241) or outpatients (N = 81) for lumbar disk herniation. Patients presenting with major neurological deficits and/or symptoms reflecting lumbar stenosis were excluded. All patients were scheduled for conservative treatment which was based on bedrest for a minimum of two weeks. Thereafter, patients were assigned for further nonoperative or operative treatment. RESULTS: According to our results only 49% of conservatively treated patients had to be operated on. At long-term follow-up with a mean observation time of 2 years as available in 125 patients, 93% of patients who did not undergo surgery were improved with respect to pain. Motor function had recovered in 60%, and sensory deficits in 58% of these cases. CONCLUSIONS: In conclusion, conservative treatment is effective and in our opinion mandatory in the setting of sciatica caused by lumbar disc herniation except for patients presenting with severe, or progressive neurological deficits.