A new study suggests that surgery for herniated discs may significantly improve pain levels for most patients, but it doesn't appear to provide any additional benefits compared to non-surgical treatments for patients receiving workers' compensation. The findings were reported in the January 1, 2010, issue of Spine.

The research team examined data on 924 patients with sciatica caused by a herniated disc.

The patients were part of a randomized trial called SPORT (which is short for Spine Patient Outcomes Research Trial). Some of the patients received surgery, while the others used non-surgical treatments (such as physical therapy).

The results showed that all the patients, regardless of the treatment, improved. However, surgery proved to have both the most immediate and longest lasting effects. Patients who had surgery recovered faster and maintained those positive results for up to 2 years after the procedure.

After the research team determined that both treatments—non-surgical and surgical—were effective, they then looked at whether workers' compensation patients recovered similarly to people not receiving workers' compensation. Out of the 924 patients studied, 12% were on workers' compensation.

As in the first part of the study, both non-surgical and surgical treatments were effective. For the non-workers' compensation patients, they reported significant improvements in their pain levels 3 months after surgery. At a 2-year follow-up, those patients reported that they still felt better.

The workers' compensation patients who had surgery recovered quickly, but they didn't report any long-lasting benefits enjoyed by those not receiving workers' compensation. At a 2-year follow-up, the workers' compensation patients had similar results to those treated with non-surgical treatments. Therefore, surgery's effects decreased over time and provided no added benefit compared to non-surgical treatments.

What the Findings Mean
This study suggests that patients receiving workers' compensation do not enjoy long-term benefits of herniated disc surgery. The results are essentially the same as those from non-surgical treatments.

Despite the findings, the research team noted they shouldn't discourage workers' compensation patients from pursuing surgery—especially if their doctor believes that it is the best course of treatment. These findings should help foster more discussion between patient and surgeon to ensure that all parties understand the risks and benefits of spine surgery.

To learn more about this study, you may read the abstract here.