Do you have severe lower back pain? Have you had it for at least one year?
Maybe your’e considering surgery?
Well, hold the phone for a minute.
According to a 4-year study performed in Norway (actually, it was two randomized control trials that merged their data), surgery provides no better long-term outcomes when compared to exercise and cognitive interventions.
The surgical group of this study (66 patients) received a very standard and widely used surgery that fused the posterolateral aspects of L4-L5 and/or L5-S1 with bone obtained from the individual and it was performed by neurosurgeons. Postoperative was decided upon by the surgeon. 92% returned with the follow-up information at the 4 year mark.
The cognitive and exercise group (58 patients) received therapy that included 1 week in an outpatient clinic, 2 weeks at home, followed up with 2 more weeks at the outpatient clinic. They were overseen by specialists in physical medicine and physiotherapy. They also met with a peer to exchange their experience. 86% returned with the follow-up information at the 4 year mark.
The overall outcome of this study showed that fusion (surgery) was not superior to exercises and cognitive intervention within 4 years when looking at outcomes such as: symptom relief, improving function, and returning to work. Also, more patients in the surgical group used more pain medication after surgery, which is interesting to say the least.
The summary of this study is this: surgery provides no better long-term improvement than conservative care at improving function, relieving symptoms, and helping you return to work for chronic lower back pain.
Brox, J. I., Nygaard, Ø. P., Holm, I., Keller, A., Ingebrigtsen, T., & Reikerås, O. (2010). Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain. Annals of the Rheumatic Diseases, 69(9), 1643–1648. http://doi.org/10.1136/ard.2009.108902
Access to the original article can be found here
