Stemcelldoc's Weblog

October 13, 2013

Low Back Pain: Fusion vs Non operative Treatment

lumbar fusion

At the Centeno-Schultz Clinic we acknowledge and know first hand the pain, restriction in range of motion and erosion of well-being associated with low back pain.

Previous blogs have discussed the clinical success of Regenexx PL in patients with lumbar disc disease and pain.

Regenexx C when injected directly into the disc has been demonstrated to reduce pain, increase level of activity and has been associated with changes on MRI.

Surgery in the form of lumbar fusion is the often held out by many as the answer.

Is it an effective therapy for low back pain?

No not according to Smith et al who examined this question.  In a retrospective analysis they reviewed consecutive patients with back pain and concordant lumbar discogram who were offered fusion.   96 patients were examined: 53 who underwent fusion  and 43  opted for non surgical  treatment.  Conclusion:  no improvement in pain, health status, satisfaction, or disability was noted in patients who underwent lumbar fusion in comparison to those who had conservative care.

Take away is that lumbar fusion is not the holy grail for low back pain.  Exhaust all treatments and make sure that all possible pain generators are considered.  These include myofascial,  facet, SI joint, ligamental instability, nerve entrapment and intervertebral disc.

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