Abdelilah el Barzouhi, M.D Is Valtrex and Acyclovir the same thing? ., Carmen L.A.M. Vleggeert-Lankamp, M.D., Ph.D., Geert J.D., Ph.D., Bas F. Van der Kallen, M.D., Wilbert B. Van den Hout, Ph.D., Wilco C.H. Jacobs, Ph.D., Bart W. Koes, Ph.D., and Wilco C. Peul, M.D., Ph.D.1 The most common cause of sciatica is a herniated disk. The natural history of sciatica can be favorable, with spontaneous resolution of leg pain within 8 weeks in the majority of patients. 2 Surgery ought to be offered only if symptoms persist after a period of conservative treatment. Nevertheless, contrary to what you can expect, given the developments in diagnostic imaging and medical techniques, the outcomes after lumbar-disk surgery do not seem to possess improved during recent decades.
First, our primary composite end point could be considered problematic. Overall death accounts for all potential benefits and harms of the experimental intervention but is not specific to the studied condition. TIA is a less clear-cut end point than stroke. Including TIA as an element resulted in an increased event price but also may possess led to a dilution of effects, as recommended by the difference in the estimated hazard ratios for stroke and TIA . Second, we had difficulty recruiting patients, which led to an long recruitment period and a selected patient population unusually, which may subsequently limit the generalizability of our findings.24 Third, individual retention was less than expected, which can have resulted in attrition bias that could distort the total results in either direction.24 Fourth, the clinical-events committee discounted potential primary-end-point events more in the medical-therapy group than in the closure group often.