Study designs of evaluations included in the review
Randomised controlled trials (RCTs) describing interventions for lower-back pain with sciatica and proven lumbar disk herniation were included if they met inclusion criteria for randomisation, concurrent controls and return to work outcomes.
Specific interventions included in the review
The following treatments were studied: chemonucleolysis using chymopapain, percutaneous and open discectomy, physical therapy, and intra-operative corticosteroid injection after microsurgical laminectomy.
Participants included in the review
The participants were patients with lower-back pain with proven disc herniation, defined as lower-back pain with radicular symptoms in a sciatic (or rarely femoral) nerve root distribution, with a corresponding abnormal intervertebral disc indicated by myelogram, computed tomography scan or magnetic resonance imaging scan.
Patients had all experienced a period of bed rest, generally of 2 to 4 weeks in duration, after presenting with disc herniation.
Outcomes assessed in the review
The outcome assessed was that of return to work.
How were decisions on the relevance of primary studies made?
One author identified the citations.