Comparing the effectiveness of surgical and non-surgical treatments for sciatica.
A systematic review and meta-analysis of 24 randomized controlled trials found that discectomy, a surgical treatment for sciatica due to lumbar disc herniation, was superior to non-surgical treatment or epidural steroid injections in reducing leg pain and disability in the immediate and short term, but the benefits declined over time. The risk of adverse events was similar between discectomy and non-surgical treatment. The evidence supporting surgical treatment for sciatica is uncertain and guidelines recommend a stepwise model of treatment starting with non-surgical treatment.