A Comparative Study of Clinical and Functional Outcomes of Conservative Versus Surgical Management in Patients with Lumbar Intervertebral Disc Prolapse

Abstract

Background: Lumbar intervertebral disc prolapse (LIVDP) is a common cause of low back pain, radiculopathy, and functional disability. Conservative and surgical management are established treatment approaches, although their relative effectiveness in providing pain relief and functional recovery remains an important clinical consideration. Aim: To compare the clinical and functional outcomes of conservative versus surgical management in patients with lumbar intervertebral disc prolapse. Materials and Methods: This hospital-based, prospective, comparative observational study was designed over 18 months and included 70 patients with MRI-confirmed lumbar disc prolapse. Patients were divided into two groups: conservative management (n=35) and surgical management (n=35). Pain intensity was evaluated using the Visual Analogue Scale (VAS), and functional disability was assessed using the Oswestry Disability Index (ODI). Clinical and functional outcomes were evaluated at baseline and at 1, 3, and 6 months. Results: In the supplied study tables, baseline mean VAS scores were 7.4±1.1 and 7.8±1.0 in the conservative and surgical groups, respectively. At six months, these decreased to 2.6±1.3 and 1.5±0.9. Mean ODI scores decreased from 58.4±10.6 to 20.4±8.6 in the conservative group and from 61.2±11.3 to 12.8±6.4 in the surgical group. Complete radicular pain relief was reported in 65.7% and 85.7% of patients, respectively. Conclusion: The supplied findings suggest greater short-term pain reduction and functional improvement following surgical management. However, both treatment approaches showed improvement, and treatment selection should consider clinical severity, neurological findings, and patient preferences.

Keywords: Lumbar disc prolapse, conservative management, lumbar discectomy, radiculopathy, Visual Analogue Scale, Oswestry Disability Index, functional outcome.