Musaed Hikmat Al-Dahhan¹*
The objective of this study is to compare between conservative and surgical intervention in patients with low back ache. A cohort clinical retrospective-prospective study is enrolling 75 patients with low back ache and diagnosed as sciatica in multi-center (Baghdad and Muthanna). The outcome of both procedures depends on the following measures: neurological deficit, Lasègue test, Sciatica Bothersomeness Index, contralateral Lasègue test. Paired t-test applied for efficacy within the group and Chi-square test to compare the efficacy of two groups. After 6 months there was significant difference between operated and non-operated patients related to Sciatica Bothersomeness Index (p = than 0,01), Lasègue test (p=0,001), neurological deficit (p = 0,01) and leg and back pain depending on the activity (p=0,002). There was no difference statistically difference between the groups related to contralateral Lasègue test (p=0,206). In conclusion, we expended formerly accepted operative indications. There were better treatment results in the surgical operated group. A fast reduction of symptoms is the main advantage of the operative treatment strategy. Patients whose pain is treated in process that is acceptable for them may decide to postpone surgery. Patient’s preference for the type of treatment is crucial for an ultimate surgical decision in cases without widespread neurological deficits.
Keywords: Low back ache; Sciatica; Neurological deficit