BMJ  2005;330 (28 May), doi:10.1136/bmj.330.7502.0

Chronic low back pain: surgery isn't conclusively better...

Surgery does not clearly achieve better results than an intensive rehabilitation programme for treating patients with chronic low back pain, and the potential risks of surgery also need to be considered. Fairbank and colleagues (p 1233) randomised 349 patients who had had low back pain for at least one year before recruitment to lumbar spine fusion or to an intensive rehabilitation programme that included exercises and cognitive behaviour therapy. After two years, all patients reported improvement and the researchers found no significant differences in outcomes between the groups, except for a marginally better score on the Oswestry disability index in favour of surgery (P = 0.045).

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Relevant Article

Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial

Jeremy Fairbank, Helen Frost, James Wilson-MacDonald, Ly-Mee Yu, Karen Barker, Rory Collins for the Spine Stabilisation Trial Group
BMJ 2005 330: 1233. [Abstract] [Full Text] [PDF]