Background: Lumbar disc herniation often causes sciatica. Although
surgery may provide relief of sciatic pain, it is uncertain how surgery
affects the relief of low-back pain. The purpose of the present prospective
study was to assess the efficacy of discectomy in the treatment of low-back
pain associated with lumbar disc herniation.
Methods: Between 1998 and 2001, forty consecutive patients with
single-level, unilateral lumbar disc herniation were treated surgically. The
first twenty patients (Group 1) underwent standard discectomy, and the second
twenty (Group 2) underwent microendoscopic discectomy. Curettage of the disc
space was not performed. All forty patients were prospectively followed, and
clinical outcomes were evaluated with use of a questionnaire. The mean
duration of follow-up was forty months.
Results: All forty patients were satisfied with the outcome. Leg
pain decreased rapidly (within one month) in all patients and continued to
decrease at the time of the latest follow-up. There was no significant
difference between the two groups in terms of leg pain, with the numbers
available (p = 0.39). A significant decrease in the mean low-back pain score
was noted at the time of the latest follow-up (p = 0.0007).
Conclusions: Excision of a herniated disc for relief of sciatica
provided rapid relief of sciatica and low-back pain. The findings of the
present small study suggest that lumbar disc herniation might be a possible
cause of low-back pain.
Level of Evidence: Therapeutic study, Level IV (case
series [no, or historical, control group]). See Instructions to Authors for a
complete description of levels of evidence.