Evidence-Based Clinical Practice Guidelines for Patients With Lumbar Disc Herniation With Radiculopathy in South Korea

Abstract

Objective: In this study, we aimed to develop evidence-based clinical practice guidelines (CPGs) for the treatment of lumbar disc herniation (LDH) with radiculopathy, tailored to South Korean clinical settings.

Methods: The guideline development process used followed the evidence-based medicine principles. Literature searches were conducted across databases, including MEDLINE (PubMed), Cochrane, Embase, and KoreaMed, using predefined search strategies. Titles and abstracts were reviewed to identify the best research evidence. Data extraction and quality assessment were performed using the Cochrane risk of bias tool and the GRADE method. Quantitative meta-analyses or qualitative synthesis were conducted based on data heterogeneity. Recommendations were assigned strength grades (A, B, C, D, I) reflecting evidence reliability.

Results: In these guidelines, comprehensive recommendations for managing LDH with radiculopathy in clinical settings were provided. International evidence and multidisciplinary expert opinions were integrated. Four key clinical questions were identified and divided into sections: surgical treatment, interventional treatment, and physical treatment/exercise. The recommendations for these questions are summarized in this article.

Conclusion: The aim of establishing these CPGs was to enhance treatment outcomes, reduce healthcare costs, and promote public health. By recognizing limitations in domestic data and the dynamic healthcare circumstances, the need for continuous revision was emphasized in these guidelines. Nonetheless, in future updates, the guidelines will be refined to improve their quality and applicability in clinical practice.