Lumbar Fusion No Better Than Exercise and Therapy in the Long Term
Am Fam Physician. 2016 Dec 1;94(11):937.
Is lumbar fusion effective for patients with chronic low back pain?
This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for the original study came from industry, and the authors have numerous conflicts of interest. Two other trials in the United Kingdom and Norway found no benefit to lumbar fusion, and the results of this study are consistent with those findings, despite what the authors conclude. (Level of Evidence = 2b)
This is an important question—one not without controversy. This study reports a mean 12.8 years of follow-up from
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