A multicentre randomised cost-effectiveness trial concerning the timing of surgery for sciatica caused by a lumbar disc herniation

Conditions

Severe sciatica caused by a lumbar disc herniation with root compression Musculoskeletal Diseases Sciatica

Abdelilah el Barzouhi, Annemieke Verwoerd, Wilco C. Peul, Arianne P. Verhagen, Geert J. Lycklama à Nijeholt et al. (9 authors)

Journal of Neurosurgery Spine2016-02-1220 citations

10.3171/2015.10.spine15858

Magnetic resonance imaging in follow-up assessment of sciatica.

el Barzouhi A, Vleggeert-Lankamp CL, Lycklama à Nijeholt GJ, Van der Kallen BF, van den Hout WB, Jacobs WC, Koes BW, Peul WC, Leiden-The Hague Spine Intervention Prognostic Study Group.

2013-03-0182 citations

10.1056/nejmoa1209250

Surgery versus prolonged conservative treatment for sciatica.

Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT, Thomeer RT, Koes BW, Leiden-The Hague Spine Intervention Prognostic Study Group.

2007-05-01484 citations

10.1056/nejmoa064039

Interventions

1. Surgery as soon as possible and within two weeks after randomisation 2. Prolonged conservative treatment by the General Practitioner. If natural history leads to aggravation of sciatica or does not

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Patients (18 - 65 years old) with at least 6 weeks and a maximum of 12 weeks sciatica not reacting to conservative treatment. An indication for surgery is made by the clinical picture with magnetic resonance imaging (MRI) confirmation of a lumbar disc herniation.

Exclusion criteria

Exclusion criteria: 1. Cauda equina syndrome 2. Severe paresis (MRC less than 3) 3. Identical complaints in the past twelve months 4. A history of spine surgery, bony stenosis, spondylolisthesis 5. Pregnancy 6. Severe comorbidity

Design outcomes

Primary

Measure	Time frame
1. Roland Disability Questionnaire 2. Visual Analogue Scale (VAS) leg pain 3. Global perceived recovery during the first year after randomisation	—

Secondary

Measure	Time frame
1. 36-item Short Form health survey 2. VAS back pain 3. Sciatica frequency and bothersomeness index 4. PROLO scale	—

Countries

Netherlands

Outcome results

None listed