Surgical vs Nonoperative Treatment for Lumbar Disk Herniation

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Abstract
Several studies have compared surgical and nonoperative treatment of patients with herniated disk, but baseline differences between treatment groups, small sample sizes with limited geographic participation, or lack of validated outcome measures in these studies limit evidence-based conclusions regarding optimal treatment.1-3 Results for the Spine Patient Outcomes Research Trial (SPORT) randomized trial for intervertebral disk herniation are reported in a companion article. In that study, both surgical and nonoperative patients experienced significant improvement over time and intent-to-treat analyses showed no significant differences between the randomized groups for the primary outcome measures.