ABSTRACT
Sciatica, characterized by leg or back symptoms along the sciatic nerve pathway, often manifests as a chronic condition lasting over 12 weeks. Decision-making between nonoperative treatment and immediate microdiscectomy for chronic sciatica remains challenging, due to the complex relationship between symptom duration, severity, and lumbar discectomy outcomes. In this systematic review, we conducted a comprehensive search across Scopus, PubMed, Web of Science, and the Cochrane Library, identifying relevant two-arm clinical trials up to September 2023. Rigorous screening and data extraction were performed by two independent reviewers, with study quality evaluated using the risk of bias 2 (RoB) tool. This meta-analysis incorporated four studies comprising 352 participants. Our analysis revealed that conservative treatment was associated with a significant reduction in leg pain and improvement in, SF mental, and physical scores compared to surgical intervention. However surgical treatment demonstrated significant improvement in back pain. In conclusion, our findings suggest that surgical intervention may be more effective than non-surgical treatment for chronic sciatica-related back pain. Conservative treatment significantly reduces leg pain while improving mental and physical health outcomes. Ultimately, our findings support conservative as the initial approach unless surgery is warranted, particularly in cases with neurological deficits or cauda equina syndrome.
ABSTRACT
INTRODUCTION: Language barriers in medicine can hinder effective communication, comprehension, and patient care. While English has emerged as the dominant language in global medicine, the importance of native languages should not be overlooked. This article aims to examine the extent of publishing in native languages by analyzing the PubMed database literature to gain further insights into the usage of native languages in medicine and medical research. METHODS: In December 2023, a comprehensive examination of the PubMed literature was conducted for each of the 55 registered languages. We searched for records published in each language (e.g., German[lang]) by applying language filters. Ethnologue provided data on the number of worldwide native speakers for each language, facilitating a comparative analysis. RESULTS: By December 2023, PubMed contained over 36 million publications, with 86.5% of them published in English. German, French, and Russian came after English, with over 700 thousand publications each. Among the languages analyzed, fourteen had fewer than 50 publications, nineteen had fewer than 100, twenty-two had fewer than 500, and twenty-five had fewer than one thousand publications. European languages were well-represented with thousands of publications each, while widely spoken languages such as Hindi and Arabic had limited representation. CONCLUSION: The production of medical research in native languages reflects the attention given to native languages in medicine and medical education within each country. It is crucial to provide due attention to these language-related issues and explore strategies for including native languages in medicine to bridge the gaps in language and medicine.
