The Journal of Bone and Joint Surgery (American). 2007;89:2558.
doi:10.2106/JBJS.8911.ebo3
© 2007 The Journal of Bone and Joint Surgery, Inc.
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Evidence-Based Orthopaedics

Review: Surgery May Be More Effective Than Unstructured Nonoperative Treatment for Chronic Low-Back Pain

Mirza SK, Deyo RA. Systematic Review of Randomized Trials Comparing Lumbar Fusion Surgery to Nonoperative Care for Treatment of Chronic Back Pain. Spine. 2007Apr 1;32:816 -23.

The first 20% of the full text of this article appears below.

Question: In patients with chronic low-back pain and disc degeneration, how do surgical and nonsurgical treatments compare?

Data sources: MEDLINE and references of review articles.

Study selection and assessment: Randomized controlled trials (RCTs) that compared surgical with nonsurgical treatment for discogenic back pain. Studies that focused specifically on comparing injections or other percutaneous treatments were not included. Study quality was assessed with use of the checklist for the Consolidated Standards of Reporting Trials.

Main outcome measures: Back-specific disability.

Main results: 4 RCTs (n = 783; age range, 18 to 65 y) met the inclusion criteria. Surgery in 2 RCTs consisted of posterolateral fusion with use of iliac crest autograft and a specific type of pedicle screw fixation; in 1 RCT, surgeons chose the surgical approach, implant, interbody cages, and bone-graft material; and in 1 RCT, patients were randomized to . . . [Full Text of this Article]

Serena Hu, MD1

1 University of California San Francisco, CA


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