SynthesisInternational orthopaedics2008
Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials.
Synthesis in International orthopaedics, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers, 6 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 6 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Pooled it
- Effectiveness and safety of ultrasound-guided needle-knife therapy for patients with spinal pain disorders: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Gait behaviors as an objective surgical outcome in low back disorders: A systematic review.Clinical biomechanics (Bristol, Avon) · 2015Pooled it
- Steps in the undertaking of a systematic review in orthopaedic surgery.International orthopaedics · 2012Pooled it
- Low back pain (chronic).BMJ clinical evidence · 2010Pooled it
- Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments.International orthopaedics · 2009Pooled it
- Trial
- Treatment of Refractory Low Back Pain Using Passive Recharge Burst in Patients Without Options for Corrective Surgery: Findings and Results From the DISTINCT Study, a Prospective Randomized Multicenter Controlled Trial.Neuromodulation : journal of the International Neuromodulation Society · 2023Trial
- Trial
- Trial
- Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain.Annals of the rheumatic diseases · 2010Trial
- A SASP-related four-gene signature associated with intervertebral disc degeneration: integrated bioinformatics analysis and validation of pinocembrin as a therapeutic candidate.Molecular biology reports · 2026Article
- The Diagnosis and Treatment of Degenerative Changes of the Lumbar Spine.Deutsches Arzteblatt international · 2025Review
- An Evidence-Based Consensus for the Use of Neurostimulation for the Treatment of Non-Surgical Low Back Pain: The NEURON Group.Journal of pain research · 2025Review
- COMBINED TECHNIQUES OF CAUDAL EPIDURAL BLOCK AND TRANSFORAMINAL NERVE ROOT BLOCK IN THE TREATMENT OF DEGENERATIVE DISEASES OF THE LUMBAR SPINE: A COST-EFFECTIVENESS ANALYSIS.Acta ortopedica brasileira · 2024Article
- Injectable decellularized nucleus pulposus tissue exhibits neuroinhibitory properties.JOR spine · 2022Article
- The Perioperative Symptom Severity of Higher Patient Health Questionnaire-9 Scores Between Genders in Single-Level Lumbar Fusion.International journal of spine surgery · 2021Article
- NF-κB inhibitor, NEMO-binding domain peptide attenuates intervertebral disc degeneration.The spine journal : official journal of the North American Spine Society · 2020Article
- Ethanol-mediated compaction and cross-linking enhance mechanical properties and degradation resistance while maintaining cytocompatibility of a nucleus pulposus scaffold.Journal of biomedical materials research. Part B, Applied biomaterials · 2019Article
- Magnetic resonance spectroscopy (MRS) can identify painful lumbar discs and may facilitate improved clinical outcomes of lumbar surgeries for discogenic pain.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 · 2019Observational
Corrections and comments
- Erratum issued
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We performed a meta-analysis of randomised controlled trials to investigate the effectiveness of surgical fusion for the treatment of chronic low back pain compared to non-surgical intervention. Several electronic databases (MEDLINE, EMBASE, CINAHL and Science Citation Index) were searched from 1966 to 2005. The meta-analysis comparison was based on the mean difference in Oswestry Disability Index (ODI) change from baseline to the specified follow-up of patients undergoing surgical versus non-surgical treatment. Of the 58 articles identified, three studies were eligible for primary analysis and one study for sensitivity analysis, with a total of 634 patients. The pooled mean difference in ODI between the surgical and non-surgical groups was in favour of surgery (mean difference of ODI: 4.13, 95%CI: -0.82 to 9.08, p = 0.10, I(2) = 44.4%). Surgical treatment was associated with a 16% pooled rate of early complication (95%CI: 12-20, I(2) = 0%). Surgical fusion for chronic low back pain favoured a marginal improvement in the ODI compared to non-surgical intervention. This difference in ODI was not statistically significant and is of minimal clinical importance. Surgery was found to be associated with a significant risk of complications. Therefore, the cumulative evidence at the present time does not support routine surgical fusion for the treatment of chronic low back pain.
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.