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Surgery Found Suitable for Discogenic Low Back Pain

Results of anterior fusion surgery better than posterolateral fusion with pedicle screws

FRIDAY, March 11 (HealthDay News) -- Surgical therapy is suitable for patients with discogenic low back pain (DLBP), with posterolateral fusion with pedicle screws (PLF) reserved for patients who are unsuitable for anterior interbody fusion (ABF) surgery, according to a study published in the March 1 issue of Spine.

Seiji Ohtori, M.D., Ph.D., from Chiba University in Japan, and colleagues compared the difference in the surgical versus nonsurgical treatment of DLBP in 41 patients in whom magnetic resonance imaging showed disc degeneration at only one level (L4/5 or L5/S1). Patients had suffered from DLBP for an average of 7.5 years with pain provocation on discography, and pain relief by anesthetic discoblock. The patients were divided into three groups: minimal treatment control, ABF group, and PLF group. Evaluation was done before therapy and two years after therapy using the visual analog scale (VAS) score, Japanese Orthopedic Association score, and Oswestry Disability Index (ODI).

The investigators found that there was no significant difference in the ODI, Japanese Orthopedic Association score, and VAS score in the three groups before therapy; however, two years post-treatment, both the surgical groups had significantly improved scores. Compared to the PLF group, the ABF group had significantly better ODI and VAS scores.

"If DLBP is strictly diagnosed, surgical therapy is suitable for its treatment. ABF gives good results, but PLF is also an option for patients who do not want anterior surgery or who present a difficult approach because of anterior vessels," the authors write.

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