Trial reportBMJ (Clinical research ed.)2005
Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial.
Trial report in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 138 papers, 15 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Physical Capability Outcomes After Single-Level ProDisc-L Total Disc Replacement or Single-Level Anterior Lumbar Interbody Fusion: a Multi-Center Clinical Trial
The Lumbar Interbody Fusion vs. Multidisciplinary Rehabilitation (LIFEHAB) Trial
Who cites it
138 citing papers in PubMed, 15 syntheses or guidelines pooled it, 508 citations in OpenAlex.
- Comparison between spinal fusion vs. nonoperative treatment for lumbar degenerative pathology: a systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis.Medicine · 2022Pooled it
- Prognostic factors for outcome following lumbar spine fusion surgery: a systematic review and narrative synthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis.BMJ (Clinical research ed.) · 2015Pooled it
- Multidisciplinary biopsychosocial rehabilitation for chronic low back pain.The Cochrane database of systematic reviews · 2014Pooled it
- Physical therapy treatments for low back pain in children and adolescents: a meta-analysis.BMC musculoskeletal disorders · 2013Pooled it
- Psychological therapies for the management of chronic pain (excluding headache) in adults.The Cochrane database of systematic reviews · 2012Pooled it
- Low back pain (chronic).BMJ clinical evidence · 2010Pooled it
- Total disc replacement surgery for symptomatic degenerative lumbar disc disease: a systematic review of the literature.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2010Pooled it
- Behavioural treatment for chronic low-back pain.The Cochrane database of systematic reviews · 2010Pooled it
- [Can failed back surgery be prevented? Psychological risk factors for postoperative pain after back surgery].Der Orthopade · 2008Pooled it
- Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials.International orthopaedics · 2008Pooled it
- Total disc replacement in the lumbar spine: a systematic review of the literature.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2006Pooled it
- Surgery for degenerative lumbar spondylosis.The Cochrane database of systematic reviews · 2005Pooled it
- Evidence-informed management of chronic low back pain with cognitive behavioral therapy.The spine journal : official journal of the North American Spine SocietyPooled it
- Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial.British journal of sports medicine · 2016Trial
- Evaluating rehabilitation following lumbar fusion surgery (REFS): study protocol for a randomised controlled trial.Trials · 2015Trial
- Description and design considerations of a randomized clinical trial investigating the effect of a multidisciplinary cognitive-behavioural intervention for patients undergoing lumbar spinal fusion surgery.BMC musculoskeletal disorders · 2014Trial
- Five-year follow-up of total disc replacement compared to fusion: a randomized controlled trial.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2013Trial
- Provocative discography screening improves surgical outcome.Wiener klinische Wochenschrift · 2013Trial
78 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by[Operations].2012
- Erratum issued
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the clinical effectiveness of surgical stabilisation (spinal fusion) compared with intensive rehabilitation for patients with chronic low back pain.
designMulticentre randomised controlled trial.
setting15 secondary care orthopaedic and rehabilitation centres across the United Kingdom.
participants349 participants aged 18-55 with chronic low back pain of at least one year's duration who were considered candidates for spinal fusion.
interventionLumbar spine fusion or an intensive rehabilitation programme based on principles of cognitive behaviour therapy.
main outcome measureThe primary outcomes were the Oswestry disability index and the shuttle walking test measured at baseline and two years after randomisation. The SF-36 instrument was used as a secondary outcome measure.
results176 participants were assigned to surgery and 173 to rehabilitation. 284 (81%) provided follow-up data at 24 months. The mean Oswestry disability index changed favourably from 46.5 (SD 14.6) to 34.0 (SD 21.1) in the surgery group and from 44.8 (SD14.8) to 36.1 (SD 20.6) in the rehabilitation group. The estimated mean difference between the groups was -4.1 (95% confidence interval -8.1 to -0.1, P = 0.045) in favour of surgery. No significant differences between the treatment groups were observed in the shuttle walking test or any of the other outcome measures.
conclusionsBoth groups reported reductions in disability during two years of follow-up, possibly unrelated to the interventions. The statistical difference between treatment groups in one of the two primary outcome measures was marginal and only just reached the predefined minimal clinical difference, and the potential risk and additional cost of surgery also need to be considered. No clear evidence emerged that primary spinal fusion surgery was any more beneficial than intensive rehabilitation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.