Surgery versus conservative care for lumbar disc herniation

INTERVENTION: Lumbar microdiscectomy versus continued non‐surgical care. The non‐surgical group was intended to mimic the natural course of healing of disc herniation, thus there was no specific program. The patients were encouraged to do isometric muscle exercises and walk right from the start; passive forms of treatment were discouraged. Treatment in the operative arm involved having a disc operation and a period of convalescence after that. Duration of treatment in that sense was about six weeks. Duration of treatment can be estimated at six weeks, after that the study involved observation only. Follow‐up of both arms is planned to last ten years, 2‐ and 6‐year results have been assessed (2‐year results published). CONDITION: Lumbar disc herniation ; Digestive System ; Other abdominal hernia PRIMARY OUTCOME: Leg pain (Visual Analogue Scale [VAS]). Assessed 6 weeks, 3 months, 6 months, 1 year, 2 years and 6 years post randomisation. A ten‐year follow‐up will take place in due course. SECONDARY OUTCOME: 1. Back pain (VAS); 2. Recovery of working ability (VAS); 3. Satisfaction with treatment (VAS); 4. Disability associated with back pain (Oswestry index); 5. Self‐assessed global recovery (Likert scale 0 ‐ 6); 6. Physical findings; ; Assessed 6 weeks, 3 months, 6 months, 1 year, 2 years and 6 years post randomisation. A ten‐year follow‐up will take place in due course. INCLUSION CRITERIA: 1. Aged 20 to 50 years, either sex 2. Sciatic pain of 6 ‐ 12 weeks' duration 3. Sciatica below knee and at least one physical finding suggestive of nerve root involvement 4. Computed tomography (CT) verified disc extrusion or sequester compatible with the clinical symptoms and findings