Chronic Low Back Pain (CLBP)

Chronic Low Back Pain (CLBP) is a major health problem in the world. This summary describes the main finding of a supplement in the journal Acta Orthopaedica which is based on the doctoral thesis by Paul Willems. In CLBP-patients imaging often reveals degenerative findings of the disc or facet joints. However those findings can also be observed in the asymptomatic population.

Lumbar spinal fusion can be beneficial for some people. However it is difficult to predict which individual patient will benefit. Many surgeons make use of some test that are assumed to predict the outcome of spinal fusion. The three most common used tests are 1) immobilization in lumbosacral orthosis, provocative discography and trial immobilization by temporary external transpedicular fixation.

The studies presented in this thesis concluded that none of those three tests are proven by current evidence. Also no patient characteristics are available for whom spinal fusion is an effective treatment. Several studies have currently shown that conservative treatment results in similar outcomes compared to spinal fusion. Conservative treatment has less complications, morbidity and costs. Therefore spinal fusion should not be proposed as a standard treatment for CLBP. > From: Willems, Acta Orthopaedica (Suppl. 349) 84 (2013) 1-37. All rights reserved to Informa Healthcare Ltd.