Surgery may be best for certain back conditions

May 18, 2012 By Angela Koenig, University of Cincinnati

Orthopedic spine surgery may be more effective than non-surgical treatment for low back disorders.

According to the latest data from the American Academy of Orthopaedic Surgeons, low back injuries accounted for nearly 1.5 million in 2006.  
 
There has long been debate over ideal treatment strategies for low back pain and associated leg pain in patients with degenerative spinal disorders.

UC Health orthopedic surgeon Ferhan Asghar, MD, along with Alan Hilibrand, MD, of Thomas Jefferson University in Pennsylvania, reviewed results from the Patient Outcomes Research Trial (SPORT) to determine its impact on decision-making in for common low back conditions. Their paper was published in the Journal of the American Academy of Orthopaedic Surgeons. 
 
They found that both nonsurgical and surgical interventions had benefits for patients, but provided better results. Furthermore, surgical fared better, even though their initial condition was worse.

"You can think of it like blood pressure,” says Asghar. "If you have high blood pressure and it starts around 200, you can take ‘drug A’ to bring it down to 180. That’s an improvement, right? However, if you take ‘drug B’ and it brings it down to 145, which one is better?

"Both surgical and nonsurgical treatments have their benefits, so nonsurgical treatment should be initiated first. When a patient has persistent symptoms, surgery is the next option.” 

Asghar stresses the importance of making treatment decisions based on research and that the SPORT study is some of the best data gathered to aid in decisions between surgical and nonsurgical interventions.  

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