International journal of rehabilitation research. Internationale Zeitschrift für Rehabilitationsforschung. Revue internationale de recherches de réadaptation
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Review Meta Analysis Comparative Study
Lumbar fusion compared with conservative treatment in patients with chronic low back pain: a meta-analysis.
We assess the effect of lumbar fusion (LF) in reducing disability among patients with chronic low back pain (CLBP) compared with conservative treatment and to weigh the clinical significance of this effect. We conducted a random-effect meta-analysis on the basis of a systematic review with research quality grading according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). The studies included were retrieved from MEDLINE and Cochrane CENTRAL databases from 1990 till January 2013. ⋯ Test for heterogeneity indicated that study imputation would favor LF but the imputed result would still be clinically insignificant with an estimated corrected reduction of ODI score of -5.51 (95% confidence interval -5.78 to -5.24). There is strong evidence that LF is not more effective than conservative treatment in reducing perceived disability because of CLBP among patients with degenerative spinal diseases. It is unlikely that further research on the subject would considerably affect this conclusion.