Spinal surgery for chronic low back pain is controversial, and the disproportionate number of fusions in private hospitals is unexplained
In developed countries, low back pain is the most common presenting symptom in primary care practice, with a lifetime prevalence of 80% for episodes of back pain.1 It affects adolescent sportsmen, pregnant women, hospital nurses and middle-aged labourers, and it peaks in the elderly.1 Back pain disrupts the rhythm of daily life, affecting work, recreation, social life and family income. The level of disability has a significant cost to the community.
- 1. Briggs AM, Buchbinder R. Back pain: a national health priority area in Australia? Med J Aust 2009; 190: 499-502. <MJA full text>
- 2. Bogduk N. Management of chronic low back pain. Med J Aust 2004; 180: 79-83. <MJA full text>
- 3. Maas ET, Ostelo RWJG, Niemisto L, et al. Radiofrequency denervation for chronic low back pain. A systematic review of randomized controlled trials. Cochrane Database Syst Rev 2015; (10): CD008572.
- 4. Fritzell P, Hagg O, Wessberg P, et al; Chronic low back pain and fusion: a comparison of three surgical techniques. Spine (Phila Pa 1976) 2001; 27: 1131-1141.
- 5. Loeser JD. What is chronic pain. Theor Med 1991; 12: 213-225.
- 6. Maus T. Imaging of the back pain patient. Phys Med Rehabil Clin N Am 2010; 21: 725-766.
- 7. Chan CW, Peng P. Failed back syndrome. Pain Med 2011; 12: 577-606.
- 8. Harris IA, Dao AT. Trends of spinal fusion surgery in Australia: 1997 to 2006; ANZ J Surg 2009; 79: 783-788.
- 9. Gibson AJN, Waddell G. Surgery for degenerative lumbar spondylosis: updated Cochrane review. Spine (Phila Pa 1976) 2005; 30: 2312-2320.
- 10. Gibson JN, Grant IC, Waddell G. The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine (Phila Pa 1976) 1999; 24: 1820-1832.
- 11. Bono CM, Lee CK. Critical analysis of trends in fusions for degenerative disc disease over the past 20 years: Influence of technique on fusion rate and clinical outcomes. Spine (Phila Pa 1976) 2004; 29: 455-463.
- 12. Harris IA, Dantanarayana N, Naylor JM. Spine surgery outcomes in workers’ compensation cohort. ANZ J Surg 2001; 82: 625-629.
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