Background: Disc herniation with radiculopathy is a disabling and costly condition, with conflicting evidence about effective treatment
Aim: To compare effectiveness of surgical and conservative treatment for lumbar disc herniation with radiculopathy
Methods: A total of 64 patients with MRI-confirmed lumbar disc herniation with radiculopathy were enrolled: 32 in the epidural steroid injection group (mean age 39,1±11,8 years, 13 males)  and 32 in the lumbar discectomy group (mean age 42,3±12,1 years, 19 males). Back and leg pain intensity (numeral rating scale), disability (Oswestry index), quality of life (SF-12) were assessed at baseline, in 10 days, 3, 6, 9 and 12 months after treatment. In conservative treatment group patients were offered to repeat MRI in 9 months.
Results: Groups did not differ at baseline. Patients in both groups showed statistically significant improvement after treatment compared to baseline (p<0,001), which maintained for timeframe of this study. When compared to conservative group, patients in the discectomy group had lower leg pain intensity in 10 days (0,97 vs 2,41, p<0,001) and in 3 months (0,84 vs 1,56, p=0,02), but there were no differences in 6 months and later. Other measurements did not show significant differences. 9 cases of disc herniation spontaneous regression were observed.
Conclusion: Results of our study show that surgical treatment of lumbar disc herniation with radiculopathy gives opportunity for faster pain relief, but in long term differences between groups diminish, suggesting that both treatment strategies can be used.

EFFECTIVE TREATMENT OPTIONS FOR LUMBAR DISK HERNIATION WITH RADICULOPATHY