Low back pain disorders: lumbar fusion?

摘要: The role of lumbar spine arthrodesis in the treatment low back pain disorders remains a highly disputed and controversial subject. There are no clear-cut indications for fusion degenerative disc disease. In fact, lumbosacral when added to appropriate decompressive surgery has failed on careful statistical analysis significantly improve results over alone. Moreover, several large series literature conjunction with discectomy, patients who developed pseudoarthrosis did as well matched cases obtained an excellent arthrodesis. These should not be surprising since there does appear exist generally accepted operational definition mechanical (lumbar instability) pain. author, however, is opinion that will prove have definite, albeit small, management intractable incapacitating disorders. This based personal clinical experience belief phenomenon syndromes do exist. Carefully performed prospective studies requisite define syndrome Given our present limitations, author suggests reserved suffering spondylotic following characteristics: disabling pain; primary complaint segmental radiologic evidence consistent "instability"; minimal or disease above proposed site arthrodesis; absent psychosocial-economic