Back pain intensity most influential in fusion decision

(HealthDay)—Patients seeing a spine surgeon are most influenced by low back pain intensity when considering whether to proceed with spinal fusion surgery, according to a study published in the Jan. 15 issue of Spine.

Christopher M. Bono, M.D., from Harvard Medical School in Boston, and colleagues surveyed 118 patients who were being seen for the first time by a spine surgeon for treatment of a non-traumatic or non-neoplastic spinal disorder. The questionnaire asked whether patients would consent to a fusion for low back pain under various scenarios presenting the risk of complications and the probability of symptom relief.

The researchers found that subjects accepted a mean of 10.2 of 24 scenarios presented, more often accepting in cases of lower risk and higher efficacy. After adjustment for a number of variables, a willingness to have surgery was significantly associated with low back pain intensity, a history of spinal injections, and being white.

"The current investigation indicates that the intensity of low back pain is the most influential factor affecting a patient's decision to accept risk of complication and symptom persistence when considering lumbar fusion," Bono and colleagues conclude. "These data could potentially change the manner in which patients are counseled to make informed choices about spinal surgery."

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