Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline

Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD.

The objective of this review was to systematically assess benefits and harms of surgery for nonradicular back pain with common degenerative changes, radiculopathy with herniated lumbar disc, and symptomatic spinal stenosis.

The article concludes that surgery for radiculopathy with herniated lumbar disc and symptomatic spinal stenosis is associated with short-term benefits compared to nonsurgical therapy, though benefits diminish with long-term follow-up in some trials. For nonradicular back pain with common degenerative changes, fusion is no more effective than intensive rehabilitation, but associated with small to moderate benefits compared to standard nonsurgical therapy.

Spine. 2009 May 1;34(10):1094-109.

Link to abstract

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