Outcome of Conservative Vs. Surgical Treatment for Lumbar Disc Herniation

Article Sidebar

Full Text PDF
Published: 2026-01-30
DOI: https://doi.org/10.61919/g90yqe03
Keywords:
Lumbar disc herniation; conservative treatment; surgical treatment; pain; motor recovery; functional outcome

Main Article Content

Muhammad Hamad
Student, Department of Health Professional Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Abdul Rehman
Operation Theater Technologist, University of Lahore Teaching Hospital, Lahore, Pakistan
Afida Wajid
Demonstrator & Corresponding Author, Department of Health Professional Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Hafiza Nimra Tariq
Student, Department of Health Professional Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Nadeem Hafeez
Respiratory Therapist, Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan
Dr. M Hussain
Medical Officer, Al Hajj Abdullah Welfare Hospital, Gujranwala, Pakistan

Abstract

Background: Lumbar disc herniation can cause persistent pain, neurological impairment, functional limitation, and reduced quality of life. Conservative management is commonly used initially, while surgery may be considered for persistent or clinically significant symptoms. Objective: To compare short-term clinical and functional outcomes between conservative and surgical management of lumbar disc herniation. Methods: This comparative observational study included 34 patients with MRI-confirmed lumbar disc herniation at Nawaz Sharif Social Security Teaching Hospital, Lahore, Pakistan. Seventeen patients received conservative treatment and 17 received surgical treatment. Outcomes included pain severity, pain improvement, motor recovery, reflex status, recurrence, return to daily activities, complications, satisfaction, and quality of life. Exact contingency-table tests were used for categorical comparisons. Results: At six weeks, mild pain was reported by 76.5% of surgical patients versus 11.8% of conservative patients (p<0.001). Complete pain relief occurred in 58.8% versus 0%, full motor recovery in 82.4% versus 0%, and reflex normalization in 100.0% versus 35.3%, respectively (all p<0.001). Recurrence within three months occurred in 5.9% of surgical and 41.2% of conservative patients (p=0.039). Full return to daily activities occurred in 82.4% versus 41.2% (p=0.032). Eight surgical patients experienced complications, whereas none were recorded in the conservative group. Conclusion: Surgical management was associated with more favorable short-term clinical and functional outcomes but also with procedure-related complications. Because treatment allocation was non-randomized, the findings should not be interpreted as definitive evidence of causal superiority

Article Details

Issue

Vol. 4 No. 2 (2026)

Section

Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

[1]
Muhammad Hamad et al. 2026. Outcome of Conservative Vs. Surgical Treatment for Lumbar Disc Herniation. Journal of Health, Wellness and Community Research. 4, 2 (Jan. 2026), 1–10. DOI:https://doi.org/10.61919/g90yqe03.

References

1. Jung B, Han J, Song J, Ngan A, Essig D, Verma R. Interventional therapy and surgical management of lumbar disc herniation in spine surgery: a narrative review. Orthop Rev. 2023;15:88931.

2. Vialle LR, Vialle EN, Henao JES, Giraldo G. Lumbar disc herniation. Rev Bras Ortop. 2010;45(1):17-22.

3. Ma Z, Yu P, Jiang H, Li X, Qian X, Yu Z, et al. Conservative treatment for giant lumbar disc herniation: clinical study in 409 cases. Pain Physician. 2021;24(5):E639.

4. Yaman O, Gushcha A, Vaishya S, Zileli M, Zygourakis C, Oertel J. The role of conservative treatment in lumbar disc herniations: WFNS Spine Committee recommendations. World Neurosurg X. 2024;22:100277.

5. Gugliotta M, da Costa BR, Dabis E, Theiler R, Jüni P, Reichenbach S, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016;6(12):e012938.

6. Dan-Azumi MS, Bello B, Rufai SA, Abdulrahman MA. Surgery versus conservative management for lumbar disc herniation with radiculopathy: a systematic review and meta-analysis. J Health Sci. 2018;8(1):42-53.

7. Buchmann N, Preuß A, Gempt J, Ryang YM, Vazan M, Stoffel M, et al. Outcome after surgical treatment for late recurrent lumbar disc herniations in standard open microsurgery. World Neurosurg. 2016;89:382-386.

8. Thackeray A, Fritz JM, Lurie JD, Zhao W, Weinstein JN. Nonsurgical treatment choices by individuals with lumbar intervertebral disc herniation in the United States: associations with long-term outcomes. Am J Phys Med Rehabil. 2017;96(8):557-564.

9. Strömqvist F, Strömqvist B, Jönsson B, Karlsson MK. Surgical treatment of lumbar disc herniation in different ages—evaluation of 11,237 patients. Spine J. 2017;17(11):1577-1585.

10. Abdullah F, Bai A, Sahil F, Kataria D, Abbas M, Ullah F, et al. Lumbar disc herniation: comparing pain relief after medical and surgical intervention. Cureus. 2021;13(6).

11. Reiman MP, Sylvain J, Loudon JK, Goode A. Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis. Br J Sports Med. 2016;50(4):221-230.

12. Takaki S, Miyama H, Iwasaki M. Cost-effectiveness analysis of intradiscal condoliase injection vs. surgical or conservative treatment for lumbar disc herniation. J Med Econ. 2023;26(1):233-242.

13. Wang W, Long F, Wu X, Li S, Lin J. Clinical efficacy of mechanical traction as physical therapy for lumbar disc herniation: a meta-analysis. Comput Math Methods Med. 2022;2022:5670303.

14. Zweig T, Enke J, Mannion AF, Sobottke R, Melloh M, Freeman BJ, et al. Is the duration of pre-operative conservative treatment associated with the clinical outcome following surgical decompression for lumbar spinal stenosis? A study based on the Spine Tango Registry. Eur Spine J. 2017;26(2):488-500.