When approached some years ago to join a multicentre randomised controlled trial of decompression for people with spinal canal stenosis, I said I couldn't possibly do this, as I firmly believed it was a good treatment in the right circumstances. However, I now had a slow growing worm in my brain. Was this in response to my own cognitive dissonance, or the subliminal effect of scepticism about the benefits of much surgery?1 No doubt I was also influenced by the number of older people I was seeing in my clinic (I have just successfully undertaken a laminectomy in a woman of quite advanced age) and the delays caused by the COVID‐19 pandemic (I have just seen a teenager with scoliosis who had been referred to me in 2021).
- 1. Harris I. Surgery, the ultimate placebo: a surgeon cuts through the evidence. Sydney: NewSouth, 2016.
- 2. Von Korff M. Studying the natural history of back pain. Spine (Phila Pa 1976) 1994; 19 (18 Suppl): 2041S‐2046S.
- 3. Tran DT, Lewin AM, Jorm L, Harris IA. Elective spinal surgery in New South Wales adults, 2001–20, by procedure funding type: a cross‐sectional study. Med J Aust 2023; 219: 303‐309.
- 4. Majid K, Truumees E. Epidemiology and natural history of low back pain. Semin Spine Surg 2008; 20: 87‐92.
- 5. Evans L, O'Donohoe, Morokoff A, Drummond K. The role of spinal surgery in the treatment of low back pain. Med J Aust 2023; 218: 40‐45. https://www.mja.com.au/journal/2023/218/1/role‐spinal‐surgery‐treatment‐low‐back‐pain
- 6. Laozi; Roberts M (transl). Dao De Jing: the Book of the Way. Berkeley: University of California Press, 2001.
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