Lumbar sciatica — comparison of results 10 years after surgical or conservative treatment

Abstract

The medical decision of whether to treat a case of lumbar disc prolapse by the conservative method or by an operation should only be made after due consideration of all relevant information. Signs of a caudal lesion, or unbearable, endless pain with neurological deficits, make the decision to operate easier. The recurring or therapy-resistant pain syndrome, often with unobtrusive neurological deficits, which is termed ‘commonplace’ lumbar sciatica, gives rise to a confrontation between the group ‘surgeons’, in particular the neurosurgeons, orthopaedic surgeons and the traumatologists, and the larger, inhomogeneous group ‘the conservative therapists’. Included in this group are the general practitioners, the conservative therapist orthopaedic specialists, doctors of physical medicine, rheumatologists, algesiologists, etc., whose methods of treatment are often even more inhomogeneous than the group itself. This confrontation, that is to say the weighing up of the pros and cons, should actually take place within each individual doctor.