Surgery versus nerve root injection for sciatica: A 5 year follow up
Research type
Research Study
Full title
Surgical microdiscectomy versus transformainal epidural nerve root injection for sciatica secondary to herniated lumbar disc: A minimum 5 year follow up
IRAS ID
314304
Contact name
Nisaharan Srikandarajah
Contact email
Sponsor organisation
The Walton Centre NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Sciatica is pain travelling down the legs. It affects 3% of the population at any point and primarily affects young working age adults. In 90% of cases, it is due to a “slipped” disc pressing on the nerve.
There can be significant risk to a patient’s life and employment if it is not managed promptly and appropriately. Most sciatica settles by itself. However, when this pain lasts for more than 6 weeks treatment can be offered as an injection or surgery but there is no care pathway in the NHS or direct comparison of these two treatments.
The Nerve Root Block Versus Surgery (NERVES) trial was an NIHR funded study across 11 NHS sites that investigated the outcomes of patients with sciatica who underwent injection or surgery. Using questionnaires that assess disability and leg pain the outcomes at 12 months between patients who underwent injection or surgery showed no significant difference, but injections were found to be more cost effective and to have less serious side effects than surgery.
There is debate but minimal scientific evidence whether these results hold true in the long term at 5 years onwards. It is important to follow up the same set of patients long term to see if the outcomes remain similar or different for each treatment.
We intend to follow up patients at least 5 years or later, who were only involved in the NERVES trial using the same initial questionnaires, which would allow us to assess if the results of the trial still hold true in the long term. This would contribute to strong evidence to inform regulatory bodies such as NICE, patients with sciatica and healthcare professionals as to the initial choice of whether a patient should undergo injection or surgery for sciatica related to a slipped disc.REC name
HSC REC A
REC reference
23/NI/0083
Date of REC Opinion
17 Jul 2023
REC opinion
Further Information Favourable Opinion