Our Summary
This research paper compares two treatments for lower back pain caused by herniated discs: discectomy (surgery to remove the herniated disc) and chemonucleolysis (an injection to dissolve the disc). The researchers looked at past studies involving over 2,400 patients to see which treatment was more effective at reducing pain, had fewer complications, was less expensive, and took less time.
They found that surgery was more effective at reducing pain, but the injection had fewer complications, was less expensive, and quicker to perform. So, while surgery may be better for those who can afford it and have the time to recover, the injection could be a good option for those with limited resources.
However, the researchers caution that more studies need to be done to confirm these findings.
FAQs
- What are the two treatments for lower back pain caused by herniated discs discussed in this research paper?
- Which treatment was found to be more effective at reducing pain, discectomy or chemonucleolysis?
- What are the potential benefits of the injection treatment, chemonucleolysis, over discectomy?
Doctor’s Tip
Overall, it is important for patients considering a discectomy to discuss all treatment options with their doctor and weigh the potential benefits and risks. It is also important to follow post-operative instructions carefully to ensure a successful recovery.
Suitable For
Patients who are typically recommended discectomy are those who have not found relief from other conservative treatments such as physical therapy, medication, and epidural steroid injections. They may have persistent lower back pain, leg pain, weakness, or numbness that is caused by a herniated disc pressing on a nerve in the spine. These patients may also have tried other treatments for an extended period of time without success, or they may have a large herniated disc that is causing severe symptoms. Ultimately, the decision to undergo discectomy surgery is made on a case-by-case basis with the patient’s individual needs and preferences in mind.
Timeline
Before discectomy:
- Patient experiences lower back pain, leg pain, and/or numbness or weakness in the legs.
- Patient may undergo imaging tests such as an MRI or CT scan to diagnose a herniated disc.
- Non-surgical treatments such as physical therapy, medication, and epidural injections may be tried first to manage symptoms.
- If symptoms do not improve with conservative treatment, surgery may be recommended.
After discectomy:
- Patient undergoes discectomy surgery to remove the herniated disc.
- Recovery time varies, but most patients can return to normal activities within a few weeks to a few months.
- Physical therapy may be recommended to help strengthen the back and prevent future injuries.
- Pain relief is typically experienced soon after surgery, with continued improvement over time.
- Follow-up appointments with the surgeon may be necessary to monitor recovery and address any complications.
What to Ask Your Doctor
- What are the potential risks and complications associated with discectomy surgery?
- How long is the recovery period after discectomy surgery?
- Are there any alternative treatments to discectomy that I should consider?
- What are the success rates of discectomy surgery for patients with similar conditions to mine?
- Will I need physical therapy or rehabilitation after discectomy surgery?
- How long do the effects of discectomy surgery typically last?
- Are there any lifestyle changes I should make after undergoing discectomy surgery?
- What is the cost of discectomy surgery and will my insurance cover it?
- How many discectomy surgeries have you performed and what is your success rate?
- Are there any long-term complications or risks associated with discectomy surgery that I should be aware of?
Reference
Authors: Mendieta-Barrera CD, De Nigris Vasconcellos F, Mamani-Julian K, Freeman PI, Garcia-Torrico F, Salolin Vargas VP, Binello E. Journal: Neurosurg Rev. 2025 Apr 3;48(1):347. doi: 10.1007/s10143-025-03501-5. PMID: 40175852