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Seminars in Neurosurgery 2000; 11(2): 177-182
DOI: 10.1055/s-2000-13224
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
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Publication History

Publication Date:
31 December 2000 (online)

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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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