An Overview on Lumbar Disc Herniation on Surgical Management Approach

Abstract

Lumbar disc herniation (LDH), the most frequent cause of sciatica, is a localized displacement of disc material beyond the usual boundaries of the intervertebral disc space, affecting 1% to 5% of the population yearly. Physiotherapy, medicinal therapy, and/or an epidural corticosteroid injection are nonsurgical first-line therapies for sciatica. However, compared to conservative treatment, surgery provides faster symptom alleviation. Over 40% of patients allocated to conservative treatment require surgery within two years. Nevertheless, surgical intervention in such cases is accompanied by several heated debates. The objective of the study is to look into the published works of literature that evaluated the role of surgery in LDH cases. Articles were selected through the use of the PubMed database in which the following points were put in (("lumbar disc herniation" [Mesh]) AND ("surgical intervention" [Mesh]) OR ("discectomy"[Mesh])). It has been found that surgical intervention in patients with LDH resulted in improved patient-reported outcomes, including subjective work capacity and quality of life, when compared to non-operative treatment. When compared to open discectomy, minimally invasive discectomy is linked to reduced blood loss, shorter operating times with no increase in overall complications that resulted in reoperation or wound infection in LDH cases. However, minimally invasive discectomy comes with a steeper learning curve.