Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study.
In this study, 40 subject who presented with sciatica attributed to lumbar disc herniation; and who had failed to respond to conservative treatment, were divided into one group who underwent microdiskectomy and another who received chiropractic treatments.
The results: "Significant improvement in both treatment groups compared to baseline scores over time was observed in all outcome measures. After 1 year, follow-up intent-to-treat analysis did not reveal a difference in outcome based on the original treatment received. However, 3 patients crossed over from surgery to spinal manipulation and failed to gain further improvement. Eight patients crossed from spinal manipulation to surgery and improved to the same degree as their primary surgical counterparts"
Their conclusion: Patients with symptomatic LDH failing medical management should consider spinal manipulation followed by surgery if warranted.