No difference in 9-year outcome in CLBP patients randomized to lumbar fusion versus cognitive intervention and exercises

Eur Spine J. 2012 Dec;21(12):2531-8. doi: 10.1007/s00586-012-2382-0. Epub 2012 Jun 6.


Purpose: To compare the 9-year outcome in patients with chronic low back pain treated by instrumented lumbar fusion versus cognitive intervention and exercises.

Methods: The main outcome measure was the Oswestry Disability Index (ODI). Secondary outcome measures included pain, fear-avoidance beliefs, trunk muscle strength, medication, and return to work.

Results: One-third of the patients randomized to cognitive intervention and exercises had crossed over and been operated and one-third of the patients allocated to lumbar fusion had been re-operated. The intention-to-treat analysis detected no differences between the two groups. The mean adjusted treatment effect for ODI was 1.9 (95 % CI -7.8 to 11.6). Analysed according to the treatment received, more operated patients used pain medication and were out of work.

Conclusions: The outcome at 9 years was not different between instrumented lumbar fusion and cognitive intervention and exercises.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Pain / rehabilitation
  • Chronic Pain / surgery
  • Cognitive Behavioral Therapy
  • Exercise Therapy
  • Female
  • Humans
  • Low Back Pain / rehabilitation*
  • Low Back Pain / surgery*
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Spinal Fusion
  • Treatment Outcome