Home E-Weekly April 19, 2016

Is Spinal Fusion Worthwhile for Back Pain?

Published: April 18, 2016

Too many patients are undergoing lumbar fusion surgery when a simple spinal decompression would relieve their back pain, according to a pair of new clinical trials.

Surgeons often supplement spinal decompression procedures with lumbar fusions in order to boost a patient's spinal stability. But lumbar fusion offers few benefits and has a higher complication rate compared to simple laminectomies, researchers say in the New England Journal of Medicine.

In the 2 new clinical trials, researchers looked at more than 300 patients undergoing decompression surgery or decompression plus lumbar fusion surgery. In one study, they found that there was no significant difference between the groups at 2 years post-op, while the other trial found a slight advantage in the fusion group. However, lumbar fusion was associated with a longer operating time, longer hospital stay and higher costs than spinal decompression alone.

"The goal of surgery in lumbar spinal stenosis is to improve walking distance and to relieve pain by decompression of the nerve roots," write the studies' lead authors in an editorial accompanying the research. "The addition of instrumented fusion — 'just to be sure' — for the treatment of the most frequent forms of lumbar spinal stenosis does not create any added value for patients and might be regarded as an overcautious and unnecessary treatment."

Kendal Gapinski

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