WikiMSK:Featured Journal Article/1 May 2023
Surgical microdiscectomy versus transforaminal epidural steroid injection in patients with sciatica secondary to herniated lumbar disc (NERVES)
The Lancet Rheumatology
ABSTRACT - This study compared the clinical and cost-effectiveness of transforaminal epidural steroid injection (TFESI) and surgical microdiscectomy for treating sciatica secondary to herniated lumbar discs. The randomized controlled trial involved 163 patients across 11 UK spinal units. At 18 weeks, the primary outcome of Oswestry Disability Questionnaire (ODQ) scores showed no significant difference between the TFESI and surgery groups. However, surgery had a higher rate of serious adverse events and was less cost-effective compared to TFESI. The researchers concluded that for patients with sciatica secondary to herniated lumbar discs and symptom duration up to 12 months, TFESI should be considered as the first invasive treatment option.