Surgical treatment of low back pain. 2012

Eron G Manusov
Clinical and Educational Services, Family Medicine Residency, Duke Southern Regional AHEC, 1601 Owens Drive, Fayetteville, NC 28304, USA. eron.manusov@sr-ahec.org

There is a need for quality trials that study optimal selection and timing of surgical treatment options. Studies are needed of cost-effectiveness and effect on long-term improvement. Until data from such studies are available, primary physicians should follow the guidelines on conservative management and aggressively evaluate the red flags of low back pain, immediately refer for neurologic deficit and bowel or bladder compromise, and focus treatment on modalities with high-quality evidence-based information. Patients who do not improve can be referred to surgeons with experience and expertise in discectomies.

UI MeSH Term Description Entries
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013123 Spinal Fusion Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed) Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses
D017116 Low Back Pain Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions. Lumbago,Low Back Ache,Low Back Pain, Mechanical,Low Back Pain, Posterior Compartment,Low Back Pain, Postural,Low Back Pain, Recurrent,Low Backache,Lower Back Pain,Mechanical Low Back Pain,Postural Low Back Pain,Recurrent Low Back Pain,Ache, Low Back,Aches, Low Back,Back Ache, Low,Back Aches, Low,Back Pain, Low,Back Pain, Lower,Back Pains, Low,Back Pains, Lower,Backache, Low,Backaches, Low,Low Back Aches,Low Back Pains,Low Backaches,Lower Back Pains,Pain, Low Back,Pain, Lower Back,Pains, Low Back,Pains, Lower Back
D017586 Diskectomy Excision, in part or whole, of an INTERVERTEBRAL DISC. The most common indication is disk displacement or herniation. In addition to standard surgical removal, it can be performed by percutaneous diskectomy (DISKECTOMY, PERCUTANEOUS) or by laparoscopic diskectomy, the former being the more common. Discectomy,Discectomies,Diskectomies
D019317 Evidence-Based Medicine An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006) Medicine, Evidence-Based,Evidence Based Medicine,Medicine, Evidence Based

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