Study Shows Low Back Surgery No Better Than Rehabilitation

New research published in the May 28, 2005 British Medical Journal suggests that surgery to relieve chronic lower back pain is no better than intensive rehabilitation and nearly twice as expensive. The study did not look at the benefits of chiropractic care, but did compare patients who underwent surgery for lower back pain and those who had rehabilitation led by physiotherapists.

Dr. Jeremy Fairbank, an orthopedic surgeon and lead researcher at the Nuffield Orthopaedic Center in Oxford, England, along with his co-researchers studied 349 chronic back pain sufferers, defined as pain lasting more than 12 months. Of the 349 patients, 176 had spinal fusion surgery while the remainder underwent intensive rehabilitation involving exercises and cognitive behavioral therapy.

Dr. Fairbank stated, “This is strong evidence that intensive rehabilitation is a good thing to do for people with chronic back pain who are thinking about having operations.” The researchers concluded that there was no evidence that surgery was any better than the rehabilitation they compared the surgery to. However, there was a big difference in price with the surgical expense being nearly twice as expensive according to the study.

Helen Campbell of the University of Oxford summed up the results by commenting, “In the short term, compared with intensive rehabilitation, surgical stabilization of the spine as first line treatment for chronic low back pain patients who have already failed standard non-operative care seems not to be cost effective.”