ARGUMENT AGAINST LUMBAR FUSION FOR LOW BACK PAIN

Henry F. Pallatroni III; Perry A. Ball

doi:10.1055/s-2000-13224

Seminars in Neurosurgery, Table of Contents

Seminars in Neurosurgery 2000; 11(2): 177-182
DOI: 10.1055/s-2000-13224

ARGUMENT AGAINST LUMBAR FUSION FOR LOW BACK PAIN

Henry F. Pallatroni, III, Perry A. Ball

Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Henry F. Pallatroni@Hitchcock.org

Abstract

ABSTRACT

The diagnosis and treatment of low back pain has always been a challenging undertaking. The etiology of the pain has been postulated to arise from a degenerated, disrupted intervertebral disc. The provocation discogram has become the standard diagnostic method for this entity. The provocation discogram is an imperfect test because of a potentially high false-positive rate and poor positive predictive value. Lumbar arthrodesis has become an accepted means of treating the ``painful disc.'' Surgical series with independent observers have reported favorable outcomes approaching only 50%. Improved methods of diagnosis along with more rigorous evaluation of surgical outcomes are needed if we are to consider lumbar arthrodesis a reasonable treatment alternative for low back pain.

KEYWORD

Lumbar fusion - provocation discogram - low back pain

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