Chronic backache is undoubtedly one of the most debilitataing of all illnesses and its cure has been controversial. Surgery is not panacea for all backaches is well known and intensive rehabilitation has its limitations too and not all patients are able to follow the regime.
Researchers in a recent study have concluded that for chronic low back pain, spinal fusion surgery is NOT better than intensive rehabilitation in relieving discomfort. The conclusions though seem a little biased against surgery and are a little round about - read this report and decide for yourself.
AdvertisementBack problems are among the commonest reason to consult a doctor and over the past several years has had the distinction of being the leading cause of work-loss. In fact almost 83 million days of work are lost per year due to backache. An estimate shows that 65 million Americans report a recent episode of back pain and 16 million adults i.e almost 8 percent of adults suffer from persistent or chronic back pain. The direct and indirect cost in United States from this problem is estimated to be over $12 billion per year.
To alleviate this chronic and nagging pain, depending upon the cause, there are usually two options - surgery or rehabilitation.
In a randomized multicenter study in Norway, investigators compared the efficacy of surgery with disc prosthesis versus non-surgical treatment i.e rehabilitation for patients with chronic low back pain.
In a two-year follow-up of randomized study, 173 patients (86 with surgery and 87 with rehabilitation) were included and treated between April 2004 and September 2007. Surgery with disc prosthesis or outpatient rehabilitation for 12-15 days was carried out.
Post study results indicate that spinal surgery was more effective than an adequate rehabilitation program for chronic low back pain. However the cost analysis also found that surgery to be much more expensive for patient than rehabilitation.
Lead author, Christian Hellum from Norway reported that "Although surgical intervention with disc prosthesis for chronic low back pain resulted in a significantly greater improvement as compared with rehabilitation, but this improvement did not clearly indicate surgery as a clear cut winner as the potential risks of surgery always remains there". Hence, the finding seems to indicate that surgery though may have a slight advantage, but the benefit is still remains too small, considering the potential inherited surgical risk for the procedure and financial expense of surgery.
Deriding the results of the surgery the authors concluded the study by stating, "Surgery for chronic low back pain is no better than intensive rehabilitation and is quite unlikely to be considered a cost-effective use of scarce healthcare resources."
1. B. Druss, Marcus, S., Olfson, M., and Pincus, H.A. (2002). "The Most Expensive Medical Conditions in America." Health Affairs, 21(4): 105-111.
2. Surgery with disc prosthesis versus rehabilitation in patients with low back pain and degenerative disc: two year follow-up of randomised study; Christian Hellum et al;BMJ 2011; 342:d2786.