Affiliations: Department of Orthopaedics, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai, China
Correspondence:
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Corresponding author: Xuhua Lu, Department of Orthopaedics, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai 200003, China. Tel.: +86 21 81886793; Fax: +86 21 81886793; E-mail:xuhualu@hotmail.com
Abstract: BACKGROUND: There are still no clearly defined clinical-practice
guidelines related to surgical intervention for chronic low back pain (CLBP) in the absence of
serious structural problems such as instability, spinal stenosis,
spondylolysis, infection, or neoplasm. There is also a lack of high-quality
evidence regarding CLBP treatment. OBJECTIVE: To compare the clinical effectiveness of lumbar surgery
vs. nonsurgical treatment for chronic low back pain. METHODS: A search was conducted using MEDLINE®,
Embase, and reference lists of articles and personal files. After a
systematic search, studies were selected on the basis of inclusion criteria.
Six articles (904 patients) met the inclusion criteria for the study. Pooled
estimates of clinical results were calculated with 95% confidence
intervals. RESULTS: All six eligible studies were independent randomized
clinical trials. Pooled data revealed that, compared with surgical
treatment, nonsurgical treatment was associated with better Oswestry
Disability Index scores. Both groups had similar Visual Analogue Scale and
Emotional Distress Scale scores as well as General Function Scores. CONCLUSIONS: For chronic low back pain, nonsurgical treatment was
shown to be effective, feasible, and safe during the follow-up period. More
randomized controlled trials are needed to compare surgical and nonsurgical
treatment of chronic low back pain.
Keywords: Chronic low back pain, meta-analysis, surgical treatment, nonsurgical treatment, Lumbar, Oswestry Disability Index
