Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20210067
Brazilian Journal of Pain
Review Article

Conservative versus surgical treatment in patients with lumbar disc herniation

Tratamento conservador versus cirúrgico em pacientes com hérnia de disco lombar

Arnon Castro Alves Filho; Allana Laís Furtado Gonçalves; Amanda de Melo Barbosa

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Abstract

BACKGROUND AND OBJECTIVES: Herniated disc is a common pathology, affecting about 5 to 10 cases per 1000 adults annually. A conservative or a surgical approach to treatment can be adopted. The present study’s objective was to evaluate each of these approaches.

CONTENTS: An integrative literature review was carried out, aiming to understand which treatment provides greater benefits in the short, medium, and long term for patients with low back disc herniation. Of the 4941 articles found, 4852 were excluded by title, 75 by abstract and 14 were selected for the study. Of these 14 studies, 10 considered the conservative approach more beneficial to patients, while 4 considered the surgical conduct more beneficial.

CONCLUSION: Surgical treatment is a good option for those cases in which patients have debilitating pain and need rapid pain relief. However, in the long run, there is no superiority of surgery over conservative treatment.

Keywords

Intervertebral disc displacement, Low back pain, Surgical procedures

Resumo

JUSTIFICATIVA E OBJETIVOS: A hérnia de disco é frequente na população, com cerca de 5 a 10 casos anualmente em cada 1.000 adultos. O tratamento pode ser feito de modo conservador ou cirúrgico. O objetivo deste estudo foi avaliar cada uma destas técnicas.

CONTEÚDO: Realizou-se uma revisão integrativa de literatura, objetivando elucidar qual tratamento proporciona maiores benefícios a curto, médio e longo prazo para os pacientes com hérnia de disco lombar. Dos 4.941 artigos encontrados, 4.852 foram excluídos pelo título, 75 pelo resumo e 14 foram selecionados para o estudo. Dos 14 estudos analisados, 10 consideraram a conduta conservadora como mais benéfica aos pacientes e 4 consideraram a conduta cirúrgica mais benéfica.

CONCLUSÃO: O tratamento cirúrgico é uma boa opção para os casos em que os pacientes apresentam dores debilitantes e que necessitam de alívio rápido da dor. Entretanto, a longo prazo, não há superioridade da cirurgia em relação ao tratamento conservador.

Palavras-chave

Deslocamento do disco intervertebral, Dor lombar, Procedimentos cirúrgicos

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Submitted date:
02/13/2021

Accepted date:
09/17/2021

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