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Spinal Fusion Surgery May Leave Some Back Pain Patients Worse Off: Study
Date:2/23/2011

By Maureen Salamon
HealthDay Reporter

WEDNESDAY, Feb. 23 (HealthDay News) -- Spinal fusion surgery for chronic low back pain -- an increasingly controversial treatment that has exploded in use over the last 20 years -- leads to higher rates of permanent disability for worker's compensation patients compared to those treated non-surgically, a new study finds.

Researchers randomly selected 725 people with low back pain treated with fusion surgery and 725 whose more conservative treatment included exercise and physical therapy. Participants were chosen from a pool of worker's compensation patients in Ohio whose on-the-job injuries between 1999 and 2001 resulted in chronic low back pain.

When the study ended in 2006, nearly all outcome categories were worse in the surgical group. Only about a quarter had returned to work after two years, compared with two-thirds of non-surgical patients. Eleven percent were permanently disabled compared with 2 percent of those without surgery.

And nearly 85 percent of the spinal fusion patients continued using opioid painkillers vs. 49 percent of non-surgical patients, with those who had had the surgery upping their daily opioid use by 41 percent.

In addition, 36 percent of the spinal fusion group had complications from the surgery, including meningitis, kidney failure and death. The re-operation rate was also 27 percent in the surgery group, and included three people who underwent four re-operations. And total days off work was also greater in the spinal fusion group (1140 days vs. 316 days).

"I'm not saying don't have lumbar fusion surgery . . . but it should be carefully evaluated before it's done," said lead study author Dr. Trang H. Nguyen, who practices occupational medicine in Cincinnati and conducted the research while a doctoral candidate at the University of Cincinnati College of Medicine. "The chances are it will have a poor outcome."

The study was p
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