FUNCTIONAL OUTCOMES OF LUMBAR DISCECTOMY VERSUS CONSERVATIVE MANAGEMENT IN LUMBAR DISC PROLAPSE: A PROSPECTIVE COMPARATIVE STUDY

Abstract

Background: Lumbar disc prolapse (LDP) is a common cause of low back pain and radiculopathy, significantly affecting functional capacity and quality of life. Although both surgical and conservative treatments are widely used, the optimal management strategy remains controversial. Objective: To compare the functional outcomes of lumbar discectomy versus conservative management in patients with lumbar disc prolapse. Methods: This prospective comparative study was conducted at Government Dindigul Medical College Hospital from January 2024 to January 2026. A total of 50 patients aged 30–60 years with clinically and radiologically confirmed lumbar disc prolapse were included. Patients were divided into two groups: surgical (lumbar discectomy) and conservative management. Outcomes were assessed using the Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) for functional status at baseline, 6 weeks, 3 months, 6 months, and 12 months. Results: Both groups showed significant improvement in VAS and ODI scores over time. The surgical group demonstrated significantly greater reduction in pain and disability at early follow-up (6 weeks and 3 months) compared to the conservative group (p < 0.001). However, by 12 months, the difference between groups was not statistically significant (VAS: p = 0.08; ODI: p = 0.06). Patients undergoing surgery returned to work earlier (6.2 ± 1.8 weeks vs 10.4 ± 2.3 weeks; p < 0.001). Minor complications were noted in the surgical group, while a subset of conservatively managed patients required delayed surgical intervention. Conclusion: Lumbar discectomy provides faster pain relief and earlier functional recovery compared to conservative management. However, long-term outcomes are comparable between the two approaches. Treatment should be individualized, with surgery reserved for patients with persistent symptoms or neurological deficits, while conservative management remains effective in selected cases.