Surgical vs Nonoperative Treatment for Lumbar Disk Herniation

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Abstract
Lumbar diskectomy is the most common surgical procedure performed in the United States for patients having back and leg symptoms; the vast majority of the procedures are elective. However, lumbar disk herniation is often seen on imaging studies in the absence of symptoms1,2 and can regress over time without surgery.3 Up to 15-fold variation in regional diskectomy rates in the United States4 and lower rates internationally raise questions regarding the appropriateness of some of these surgeries.5,6