Evidence map›Paper›PMID 34732096›Full record

ArticleGlobal spine journal2023

Early Versus Delayed Microdiscectomy for Chronic Sciatica Lasting 4-12 Months Secondary to Lumbar Disc Herniation: A Secondary Analysis of a Randomized Controlled Trial.

Christopher S Bailey, Andrew Glennie, Parham Rasoulinejad, Andrew Kanawati, David Taylor, Keith Sequeira, Thomas Miller, Jim Watson, Richard Rosedale, Stewart I Bailey and 3 more

Open access · goldAbstract read
In one paragraph

Article in Global spine journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. The effect of symptom duration on the outcomes of lumbar discectomy for radicular pain secondary to lumbar disc herniation: 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 · 2025
    Pooled it
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Christopher S BaileyDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Andrew GlennieDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Parham RasoulinejadDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Andrew KanawatiDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.ORCID 0000-0002-6696-764X
David TaylorDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Keith SequeiraRegional Rehab and Spinal Cord Injury Outpatients, Parkwood Institute, London, Ontario, Canada.ORCID 0000-0002-1429-800X
Thomas MillerSchulich School of Medicine and Dentistry, Western University, London, Ontario Canada.
Jim WatsonDepartment of Anesthesia and Perioperative Medicine, St. Joseph's Health Care London, London, Ontario, Canada.ORCID 0000-0002-2275-5864
Richard RosedaleOccupational Health and Safety, London Health Sciences Centre, London, Ontario, Canada.
Stewart I BaileyDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Kevin R GurrDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Fawaz SiddiqiDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.
Jennifer C UrquhartDepartment of Surgery, London Health Sciences Center, London, Ontario, Canada.ORCID 0000-0002-9393-814X
Western University · CALondon Health Sciences Centre · CALawson Health Research Institute · CAParkwood Institute · CASt Joseph's Health Care · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the effect of delaying surgery on clinical outcome in patients with chronic sciatica secondary to lumbar disc herniation.

methodsPatients with sciatica lasting 4-12 months and lumbar disc herniation at the L4-L5 or L5-S1 level were randomized to undergo microdiscectomy (early surgery) or to receive 6 months of nonoperative treatment followed by surgery if needed (delayed surgery). Outcomes were leg pain, Oswestry Disability Index score (ODI), back pain, SF-36 physical component (PCS) and mental component (MCS) summary scores, employment, and satisfaction measured preoperatively and at 6 weeks, 3 months, 6 months, and 1 year after surgery.

resultsOf the 64 patients in the early surgery group, 56 underwent microdiscectomy an average of 3 ± 2 weeks after enrollment. Of the 64 patients randomized to nonoperative care, 22 patients underwent delayed surgery an average of 53 ± 24 weeks after enrollment. The early surgery group experienced less leg pain than the delayed surgery group, which was the primary outcome, at 6 months after surgery (early surgery 2.8 ± .4 vs delayed surgery 4.8 ± .7; difference, 2.0; 95% confidence interval, .5-3.5). The overall estimated mean difference between groups significantly favored early surgery for leg pain, ODI, SF36-PCS, and back pain. The adverse event rate was similar between groups.

conclusionsPatients presenting with chronic sciatica treated with delayed surgery after prolonging standardized non-operative care have inferior outcomes compared to those that undergo expedited surgery.

Indexed as

discectomydisc herniationlumbarnonoperativesciatica

Identifiers

PMID34732096
PMCPMC10556926
OpenAlexW3210442702

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.