Lumbar fusion versus nonoperative management for treatment of discogenic low back pain: a systematic review and meta-analysis of randomized controlled trials

Journal of Spinal Disorders & Techniques
Mohamad BydonAli Bydon

Abstract

Systematic review and meta-analysis of randomized controlled trials (RCTs). To evaluate the current evidence comparing lumbar fusion to nonoperative management for the treatment of chronic discogenic low back pain. Discogenic low back pain is a common and sometimes disabling condition. When the condition becomes chronic and intractable, spinal fusion may play a role. A systematic review of the literature was conducted using the PubMed and CENTRAL databases. We included RCTs that compared lumbar fusion to nonoperative management for the treatment of adult patients with chronic discogenic low back pain. A meta-analysis was conducted to assess the improvement in back pain based on the Oswestry Disability Index (ODI). Five RCTs met our inclusion criteria. A total of 707 patients were divided into lumbar fusion (n=523) and conservative management (n=134). Although inclusion/exclusion criteria were relatively similar across studies, surgical techniques and conservative management protocols varied. The pooled mean difference in ODI (final ODI-initial ODI) between the nonoperative and lumbar fusion groups across all studies was -7.39 points (95% confidence interval: -20.26, 5.47) in favor of lumbar fusion, but this difference was not s...Continue Reading

Associated Clinical Trials

References

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Citations

Aug 15, 2015·Spine·Gregory D SchroederJason W Savage
Sep 13, 2015·The Spine Journal : Official Journal of the North American Spine Society·Rune HedlundUNKNOWN Swedish Lumbar Spine Study Group
Aug 11, 2015·Pain Management·Laxmaiah Manchikanti, Joshua A Hirsch
Jul 22, 2015·ACS Applied Materials & Interfaces·Hui TaoDike Ruan
Dec 19, 2015·Spine·Steven J Atlas
Aug 30, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Mehul J DesaiMichael Gofeld
Sep 7, 2016·The Spine Journal : Official Journal of the North American Spine Society·Stephan BeckerMichael H Heggeness
Jul 12, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Niek KoendersJ Bart Staal
Nov 11, 2019·Current Pain and Headache Reports·Lei ZhaoAlaa Abd-Elsayed
Mar 27, 2020·JOR Spine·Takashi YurubeKenichiro Kakutani
Nov 21, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Erdi İmreEbru Taştekin
Apr 7, 2020·Neurospine·Yoshiki TakeokaKotaro Nishida
Feb 10, 2021·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·N A KonovalovE S Brinyuk
Feb 27, 2021·Clinical Spine Surgery : a Spine Publication·Arash J SayariHoward S An
Jun 12, 2021·Lancet·Nebojsa Nick KnezevicSteven P Cohen
Jun 2, 2021·Lancet·Steven P CohenWilliam M Hooten

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