Neurocirugia (Asturias, Spain) · 2017
[Lumbar disc herniation: Natural history, role of physical examination, timing of surgery, treatment options and conflicts of interests].
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Delgado-López Pedro David, Rodríguez-Salazar Antonio, Martín-Alonso Javier, Martín-Velasco Vicente
Аннотация
INTRODUCTION: Indication for surgery in lumbar disc herniation (LDH) varies widely depending on the geographical area.
DEVELOPMENT: A literature review is presented on the natural history, role of physical examination, timing of surgery, evidence-based treatment, and conflicts of interests in LDH. Surgery is shown to provide significant faster relief of pain compared to conservative therapy, although the effect fades after a year. There is no treatment modality better than the rest in terms of pain control and neurological recovery, nor is there a surgical technique clearly superior to simple discectomy. The lack of sound scientific evidence on the surgical indication may contribute to its great geographical variability.
CONCLUSIONS: Since LDH has a favourable natural history, neuroimaging and surgery should not be considered until after a 6-week period. It is necessary to specify and respect the surgical indications for LDH, avoiding conflicts of interests.
DEVELOPMENT: A literature review is presented on the natural history, role of physical examination, timing of surgery, evidence-based treatment, and conflicts of interests in LDH. Surgery is shown to provide significant faster relief of pain compared to conservative therapy, although the effect fades after a year. There is no treatment modality better than the rest in terms of pain control and neurological recovery, nor is there a surgical technique clearly superior to simple discectomy. The lack of sound scientific evidence on the surgical indication may contribute to its great geographical variability.
CONCLUSIONS: Since LDH has a favourable natural history, neuroimaging and surgery should not be considered until after a 6-week period. It is necessary to specify and respect the surgical indications for LDH, avoiding conflicts of interests.
Предметные рубрики MeSH
AdultConflict of InterestConservative TreatmentDiskectomyEvidence-Based MedicineFemaleHumansIntervertebral Disc DisplacementLow Back PainLumbar VertebraeMaleMeta-Analysis as TopicMiddle AgedMinimally Invasive Surgical ProceduresPain ManagementPhysical ExaminationRemission, SpontaneousRestSciaticaTreatment Outcome