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Factor Finding to Maximize Results after Back Fusion Surgery

Doctors from around the world are gathering data about back pain patients. They hope to find ways to predict which patients will get better with surgery and which patients will do just as well without surgery. Many physical, psychological, social, and work-related factors have been studied.

The Swedish Lumbar Spine Study has a new report about predictors after spinal fusion surgery. Doctors from 19 medical centers joined this study. The patients all had low back pain for at least two years before having surgery. The researchers found two things that helped predict success after surgery.

Patients with a neurotic personality had a worse result after surgery. A "neurotic" patient was described as someone who is tense, stiff, restless, uneasy, and easily panicked. The authors of this study suggest that patients who aren't neurotic have the best odds of getting better after surgery for low back pain. Nonneurotic patients seem to cope with pain and discomfort in a positive way.

A short sick leave also pointed to a better result. This was true for both the patients who had surgery and those who were treated without surgery. Being younger was an added bonus for patients who had back surgery. Younger, nonneurotic patients had the best return-to-work record.

This study can help guide doctors when choosing low back pain patients who will get better with surgery. The best patients for surgery are young, without signs of neurosis, and with a recent diagnosis of chronic low back pain. With the right patient, surgery without long delays has the best result.


O. Hägg, et al. Predictors of Outcome in Fusion Surgery For Chronic Low Back Pain. A Report From the Swedish Lumbar Spine Study. In European Spine Journal. January/February 2003. Vol. 12. No. 1. Pp. 22-33.

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