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The European Journal of Public Health 1996 6(1):15-20; doi:10.1093/eurpub/6.1.15
© 1996 by European Journal of Public Health
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ORIGINAL ARTICLES

The effectiveness of treatement for the prolapsed lumbar intervertebral disc

A review of the literature

MERYL DEANE, ANNE J. MOORE, ANDREW F. LONG and STEPHEN HARRISON

Nuffield Institute for Health Services Studies Leeds, UK
Atkinson Morley's Hospital London, UK

Correspondence: Meryl Deane, Lecturer & consultant in public health medicine, University of Hull, Cottingham Road, Hull HU6 7RX UK, tel. +44 1482 466027, Fax +44 1482 441408

Literature relating to the management of prolapsed lumber intervertebral discs was reviewed in order to assess the effectiveness of current medical care. Five aspects of care were addressed: the effectiveness of alternative forms of conservative treatment, the length of time necessary for a satisfactory trial of conservative management, the usefulness or otherwise of routine lumber spine X-rays, the type of investigation best suited to confirm the nature and level of the lesion in cases where surgical intervention is considered and the form of intervention that provides the best outcome for the patient. Plain lumber spine X-rays were found to be unnecessary as a routine investigation. All conservative treatment options were found to offer at most short-term benefit only and did not affect the long-term outcome. Computerized tomographic scans or magnetic responce imaging are most suitable for providing confirmation of the level of the lesion. Myelograms should not be used routinely. Minimally invaslve surgery appears to have the best outcomes and to be the most acceptable to the patient.

Keywords: prolapsed lumber interverbral discs, computerized tomographic scans, lumber spine X-rays, minimally invasive surgery


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