Posted by: Chris Maloney | October 3, 2010

Back pain: shouldn’t surgery have more studies?

The Disc Low Back Leg Pain

Image by planetc1 via Flickr

I went looking for more studies comparing surgical intervention for back pain with conservative treatments, and I found nothing new.  Backing off from that, I went looking for long term studies on back surgery outcomes.  We have lots of short term studies, but what about following patients for as long as five or ten years?  Fifteen or twenty years?  Wouldn’t you think that surgeons would want to know whether they actually cured the issue or whether they simply delayed it.  And we have so many different subtypes of surgical intervention, surely someone must be biting at the bit to prove that his particular nip and tuck is the best overall?  Alas, as the Cochrane database says, studies are limited.  We have no comprehensive, long term studies on surgical outcomes over a ten or twenty year period for lumbar surgical intervention in chronic pain

What is more troubling is that some experts question even getting the screenings done.  The video is entitled:  “Imaging Studies of Lower Back Offer No Benefit to Those Without Serious Underlying Conditions” and it covers the Lancet metanalysis of screening outcomes. 

I’ve added what I could find on www.maloneymedical.com under What Do I Treat and Back Pain (update at the top of the page).  I think unless things change I’m going to counsel patients against unnecessary screening for mild to moderate back pain. 

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