Advanced scientific considerations for surgery in patients with lumbar disk herniation

Abstract

This chapter discusses key aspects in the diagnosis, prognosis, and surgical treatment of lumbar disc herniation with persistent complaints. The importance of natural history, clinical assessments, and imaging with MRI is viewed with regard to decision for surgery. The appropriate wait and see time before indicating surgery is regarded in relation to the comparison of conservative treatment with surgery. Existing evidence shows that short-term improved outcome should be balanced against the surgical burden and associated risks. Further, comparative evidence between different surgical techniques shows no clear advantage of different techniques.