Evidence for surgery in degenerative lumbar spine disorders
Low Back Pain (LBP) has a high lifetime prevalence rate. This article reviews the available evidence on the effectiveness of surgical interventions for some conditions resulting in low back pain (LBP) or spine-related irradiating leg pain. The most important findings are presented below:
- The current evidence does not support surgery as effective treatment compared to high-intensity conservative interventions for the treatment of discogenic LBP without disc herniation or spinal stenosis.
- In patients with disc herniations surgery can lead to short-term benefits of leg pain, to a lesser extent for LBP. However, no difference between surgery and conservative treatment is present at the 1-year follow-up
- In spondylolisthesis (type II and III) surgery appears to lead to better clinical improvements compared to conservative treatment. Fusion appears to be superior to decompression techniques.
- In patients with degenerative spinal stenosis surgery resulting in better outcomes, both in leg pain and disability, compared to conservative interventions. However the evidence is not consistent and the quality of the studies was not all of high quality. > From: Jacobs et al., Beste Pract Res Clin Rheumatol 27 (2013) 673-84. All rights reserved to Elsevier Ltd.
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