Trial reportBMJ (Clinical research ed.)2008
Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04043611 (Effect of Elongation Longitudinaux Avec Decoaption Osteo-Articulaire Exercises in Lumbar Disc Protrusion), which is not on this map. Cited by 127 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Elongation Longitudinaux Avec Decoaption Osteo-Articulaire Exercises in Lumbar Disc Protrusion
Who cites it
127 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Comparative efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.BMC surgery · 2025Pooled it
- Effect of obesity on results of endoscopic versus open lumbar discectomy: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2023Pooled it
- The incidence of regression after the non-surgical treatment of symptomatic lumbar disc herniation: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2020Pooled it
- The utility of diagnostic selective nerve root blocks in the management of patients with lumbar radiculopathy: a systematic review.BMJ open · 2019Pooled it
- Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.Medicine · 2019Pooled it
- Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group.Pain practice : the official journal of World Institute of Pain · 2019Guideline
- National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Guideline
- Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Surgery versus conservative care for neck pain: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2013Pooled it
- Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2012Pooled it
- Herniated lumbar disc.BMJ clinical evidence · 2011Pooled it
- Herniated lumbar disc.BMJ clinical evidence · 2009Pooled it
- Lumbar facet joint osteoarthritis as the underlying reason for persistent low back pain after minimally invasive discectomy.Archives of orthopaedic and trauma surgery · 2023Trial
- Microdiscectomy compared with transforaminal epidural steroid injection for persistent radicular pain caused by prolapsed intervertebral disc: the NERVES RCT.Health technology assessment (Winchester, England) · 2021Trial
- Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study.Scientific reports · 2021Trial
- Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2017Trial
- Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2017Trial
- Trial
- The prognostic value of electrodiagnostic testing in patients with sciatica receiving physical therapy.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2015Trial
67 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the effects of early lumbar disc surgery compared with prolonged conservative care for patients with sciatica over two years of follow-up.
designRandomised controlled trial.
settingNine Dutch hospitals.
participants283 patients with 6-12 weeks of sciatica.
interventionsEarly surgery or an intended six months of continued conservative treatment, with delayed surgery if needed.
main outcome measuresScores from Roland disability questionnaire for sciatica, visual analogue scale for leg pain, and Likert self rating scale of global perceived recovery.
resultsOf the 141 patients assigned to undergo early surgery, 125 (89%) underwent microdiscectomy. Of the 142 patients assigned to conservative treatment, 62 (44%) eventually required surgery, seven doing so in the second year of follow-up. There was no significant overall difference between treatment arms in disability scores during the first two years (P=0.25). Improvement in leg pain was faster for patients randomised to early surgery, with a significant difference between "areas under the curves" over two years (P=0.05). This short term benefit of early surgery was no longer significant by six months and continued to narrow between six months and 24 months. Patient satisfaction decreased slightly between one and two years for both groups. At two years 20% of all patients reported an unsatisfactory outcome.
conclusionsEarly surgery achieved more rapid relief of sciatica than conservative care, but outcomes were similar by one year and these did not change during the second year. TRIAL REGISTRY: ISRCT No 26872154.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.