Evidence map›Paper›PMID 38832179›Full record

ReviewCureus2024

Surgical vs. Conservative Management of Chronic Sciatica (>3 Months) Due to Lumbar Disc Herniation: Systematic Review and Meta-Analysis.

Ali Hammed, Almonzer Al-Qiami, Hamza Alsalhi, Amjad Almansi, Mahmoud Massoud, Ahmad Alzawahreh, Abdelrahman Hamouda, Christian Tanislav

Abstract readReview
In one paragraph

Review in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

8 authors.

Ali HammedDepartment of Geriatrics and Neurology, Diakonie Hospital Jung Stilling, Siegen, DEU.
Almonzer Al-QiamiNeurological Surgery, Faculty of Medicine, Kassala University, Kassala, SDN.
Hamza AlsalhiNegida Academy, Medical Research Group of Egypt, Arlington, USA.
Amjad AlmansiNeurology, Prince Hamza Hospital, Amman, JOR.
Mahmoud MassoudNeurology, Faculty of Medicine, Al-Azhar University, Damietta, EGY.
Ahmad AlzawahrehNeurology, Faculty of Medicine, The Hashemite University, Zarqaa, JOR.
Abdelrahman HamoudaDepartment of Neurologic Surgery, Mayo Clinic, Rochester, USA.
Christian TanislavDepartment of Geriatrics and Neurology, Diakonie Hospital Jung Stilling, Siegen, DEU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sciatica, characterized by leg or back symptoms along the sciatic nerve pathway, often manifests as a chronic condition lasting over 12 weeks. Decision-making between nonoperative treatment and immediate microdiscectomy for chronic sciatica remains challenging, due to the complex relationship between symptom duration, severity, and lumbar discectomy outcomes. In this systematic review, we conducted a comprehensive search across Scopus, PubMed, Web of Science, and the Cochrane Library, identifying relevant two-arm clinical trials up to September 2023. Rigorous screening and data extraction were performed by two independent reviewers, with study quality evaluated using the risk of bias 2 (RoB) tool. This meta-analysis incorporated four studies comprising 352 participants. Our analysis revealed that conservative treatment was associated with a significant reduction in leg pain and improvement in, SF mental, and physical scores compared to surgical intervention. However surgical treatment demonstrated significant improvement in back pain. In conclusion, our findings suggest that surgical intervention may be more effective than non-surgical treatment for chronic sciatica-related back pain. Conservative treatment significantly reduces leg pain while improving mental and physical health outcomes. Ultimately, our findings support conservative as the initial approach unless surgery is warranted, particularly in cases with neurological deficits or cauda equina syndrome.

Indexed as

back vas scorechronic sciaticaconservative managementleg vas scorelumbar disc herniationsurgical management

Identifiers

PMID38832179
PMCPMC11145364

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.