Sciatica: which intervention?

摘要

Conservative management of sciatica may fail to bring relief, and a more invasive treatment is required. Evidence shows that an epidural injection of corticosteroids produces short term relief; adverse effects are few and not usually serious. Chemonucleolysis or discectomy have higher success rates but a greater risk of more serious adverse events. Long term results after surgery are only slighdy better than non-surgical intervention. Patients require an individualised approach using best evidence and the application of clinical art and expertise.