Decision Making for Treatment of Persistent Sciatica

Lumbar disk herniations are among the most frequent causes of sciatica.1,2 Fortunately for patients, sciatica is generally self-limited and resolves within 3 months in 70 to 90% of patients.2 When symptoms do not improve, surgical diskectomy has been an accepted treatment since it was first described in the Journal nearly a century ago.3 During the past 20 years, several studies, including the Maine Lumbar Spine Study,4 and clinical trials, including the Spine Patient Outcomes Research Trial (SPORT),5-7 have characterized the outcomes of surgical and nonsurgical treatment in patients with sciatica and lumbar disk herniation. These and other reports have supported . . .