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Spinal Fusion Surgery May Leave Some Patients Worse Off

A new study in the USA has found that spinal fusion surgery leads to higher rates of permanent disability for worker's compensation patients compared to those treated non-surgically.

Spinal fusion surgery is a procedure by which adjacent vertebrae are fused together to treat degenerative back conditions. The study authors note that the use of the procedure has increased 220percent in the USA since 1990.

The study randomly selected 725 people with low back pain treated with fusion surgery and 725 whose treatment included exercise and physical therapy. Participants were chosen from a pool of worker's compensation patients whose on-the-job injuries between 1999 and 2001 resulted in chronic low back pain (study author: Trang H. Nguyen, M.D., Ph.D., occupational medicine specialist, Cincinnati, Ohio).

The study assessed participants according to various treatment outcome categories. When the study ended in 2006, nearly all outcome categories were worse in the surgical group. Only about a quarter had returned to work after two years, compared with two-thirds of non-surgical patients. 11% were permanently disabled compared with 2 % of those without surgery.

Further nearly 85 % of the spinal fusion patients continued using painkillers vs. 49 percent of non-surgical patients, with those who had had the surgery increasing their daily use by 41 percent.

In addition, 36 % of the spinal fusion group had complications from the surgery, including meningitis, kidney failure and death. The re-operation rate was also 27 percent in the surgery group, and included three people who underwent four re-operations. Total days off work was also greater in the spinal fusion group (1140 days vs. 316 days).
Posted : Friday, April 1, 2011