TUESDAY, May 24, 2005 (HealthDay News) -- British researchers have found no clear evidence that spinal fusion surgery for chronic low back pain is better than intensive rehabilitation in relieving discomfort.
What's more, these surgeries may not be as cost-effective as other interventions, the researchers added.
Published online May 23 in the British Medical Journal, the study included 349 people with chronic low back pain, defined as pain lasting more than a year. Patients were divided into two groups: 176 underwent spinal fusion surgery and 173 were enrolled in an intensive rehabilitation program that involved daily exercises and cognitive (mental) behavior therapy.
Two years into the study, 38 of the patients assigned to rehabilitation had gone on to receive surgery as well, compared with seven surgery patients who had received both treatments. This finding seems to indicate that surgery has a slight advantage, but the study authors believe the benefit is still too small, considering the potential risk and financial expense of surgery.
They conclude there is no clear proof that surgery is better than rehabilitation and suggest that rehabilitation should routinely be made available to people with chronic low back pain.
Their cost analysis also found that, on average, surgery is much more expensive per patient than rehabilitation.
The bottom line: treatment protocols that mandate surgery as a first-line therapy for chronic low back pain may not be cost-effective, the researchers said. However, they caution that their conclusion could change if more patients who received rehabilitation go on to require surgery in the future.
More information
The U.S. National Institute of Neurological Disorders and Stroke has more about low back pain.
