About 1-2% of people will suffer from lumbar disc herniation in their lifetime, most often in men aged 40-60 years. although symptoms vary greatly between individuals, most have sudden onset of unilateral or bilateral neurogenic leg pain, often accompanied by low back pain. 70% of patients have leg pain that resolves within 6 weeks of onset. Therefore, conservative treatment of lumbar disc herniation should usually be chosen first, including health promotion and counseling, non-steroidal anti-inflammatory drugs (NSAIDS) and analgesics, physical therapy and epidural injections. Most international guidelines now recommend that surgery should be considered if symptoms persist after a certain period of regular conservative treatment. However, there is no definitive conclusion as to whether the prolonged duration of symptoms associated with lumbar disc herniation has an impact on the final outcome and whether this impact differs between conservative and surgical treatment. The Spine Patient Outcomes Research Trial (SPORT) addressed this issue by conducting a prospective randomized controlled study with a 6-month duration of symptoms associated with lumbar disc herniation as the cut-off for observational comparison. Patients were randomized to conservative or surgical treatment, with the surgical approach being a traditional posterior open discectomy and the conservative treatment being “minimal non-surgical treatment” consisting of active physical therapy, health education and counseling, and home rehab instruction, and NSAIDS medication. In addition to these basic measures, conservative patients may choose other non-surgical treatment options under the guidance of their physicians. A total of 1192 eligible patients were enrolled, of whom 927 patients had less than 6 months of disease and 265 had more than 6 months of disease. Regular follow-up was performed for at least 4 years after inclusion in the study. The results found that the final primary outcome evaluation index was poorer in patients with a disease duration of more than 6 months, whether treated conservatively or surgically. In the surgically treated group, those with less than 6 months of disease duration had significantly better SF-36 physical pain values (mean improvement, 48.3 vs 41.9, p < 0.001) and greater improvement in motor function (47.7 vs 41.2; p < 0.001) and Oswestry dysfunction index ( C41.1 vs C34.6; p < 0.001). The results of the non-surgical treatment group showed similar trends to those of the surgical treatment group, with specific results for SF-36 (mean improvement, 31.8 vs 21.4, p < 0.001), motor function (29.5 vs 22.6, p = 0.015), Oswestry dysfunction index (-24.9 vs - 18.5, P=0.006). In addition, all major indicators were better in the surgical treatment group than in the non-surgical treatment, but there was not much relationship with the duration of symptoms. That is, the longer the duration of symptoms before starting treatment for lumbar disc herniation, the worse the final outcome, both for surgical and non-surgical treatment. And although surgical treatment was more effective than non-surgical treatment, it was not related to the length of the disease before treatment. From this study, both patients and orthopedic surgeons should recognize that treatment of lumbar disc herniation should involve early intervention, whether surgical or non-surgical.