Surgery tops physical and drug therapies for treating the pain and loss of function caused by herniated discs in the lower back, according to a study published in the Dec. 1 issue of the journal Spine.

Dartmouth Medical School???s James A. Weinstein, DO, MS, and his team of researchers studied 1,244 patients who presented with herniated discs in the lumbar spine. The researchers randomly assigned 501 patients to undergo discectomy and gave the remaining 743 patients the option to choose between surgical and nonsurgical treatments. Of those with a choice, 521 patients underwent surgery and 222 patients opted for nonsurgical care.

At four years post-op, patients undergoing discectomy reported less pain and more improved functioning than the nonsurgical group, the study notes. Dr. Weinstein???s team discovered, however, that only 20 percent of patients in both groups had healed enough to return to work, necessitating a cost-benefit analysis of scheduling workers??? compensation cases for surgery.

For more on minimally invasive spine procedures, check out "Healing Herniated Discs" from OSM's Manager???s Guide to Spine Surgery.

—Daniel Cook