Spinal Fusion Surgery May Leave Some Back Pain Patients Worse ... (ublished in the Feb. 15 issue of Spine....)

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Spinal Fusion Surgery May Leave Some Back Pain Patients Worse Off: Study

Date:2/23/2011

ublished in the Feb. 15 issue of Spine.

Spinal fusion surgery, which fuses adjacent vertebrae together to treat degenerative back conditions, has increased 220 percent since 1990, the study authors said.

Research published in the Journal of American Medical Association in April 2010, for example, indicated that the use of complex surgical procedures such as spinal fusion to treat back pain had risen 15-fold over the prior six years despite the fact that the operations are riskier and not necessarily more effective.

Few studies, however, have focused solely on spinal fusion outcomes in worker's compensation patients, Nguyen said.

The findings, Nguyen added, are "very consistent with previous studies. The result we've provided is nothing new."

Most of the patients in Nguyen's study had degenerative disc disease, herniated discs or nerve root disease.

But the surgery may work well for those with other conditions, such as unstable spines, severe vertebral fractures, cancer or extremely herniated discs, Nguyen said.

Dr. Leah Y. Carreon, clinical research director of the Norton Leatherman Spine Center in Louisville, Ky., questioned whether the surgical group could be compared fairly to the non-surgical group since certain back conditions are more likely to respond to surgery than others.

"They're looking at the nebulous diagnosis of chronic low back pain, which is what we're trying to veer away from," Carreon said.

Carreon said she doesn't believe the two worker's compensation groups in the study are comparable.

"I'm not sure the amount of disability is the same for the non-surgical group as the surgical group," she said. "Despite the numbers [of participants], you'd think they would come up with a homogenous group, but I don't have any proof of that. They still did not come up with an apples-to-apples comparison."

Dr. E. Kano Mayer, a staff physician and physiatrist (rehabilitation physi
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