Conservative treatment and manipulation pre lumbar disc surgery - 2010

This paper is of use to patients considering surgery for disc prolapse and whether to undergo physical treatment first. It also has value for Gp's :-
Spine J. 2010 Mar 31. [Epub ahead of print]
Cost and use of conservative management of lumbar disc herniation before surgical discectomy.
Daffner SD, Hymanson HJ, Wang JC.
Department of Orthopaedics, West Virginia University, Morgantown, WV 26506-9196, USA.
This USA based study looked at the cost of conservative treatment for those who did and did not ultimately require spinal surgery.
From a study of 30,000 patients the authors concluded that ' Although a large number of patients will ultimately require surgical intervention, given that many patients will improve with nonoperative therapy, a trial of conservative management is appropriate.' Additional studies to identify patients who may ultimately fail nonoperative treatment and would benefit from early discectomy would be beneficial'.Conservative treatment in this context included manipulation.
From this, pre surgery conservative treatment looks justified, with the rider that those who are blatantly heading for surgery should be identified early and referred to a spinal surgeon.

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