Surgical vs Non-Surgical Approach to Low Back Pain

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Lumbar fusion is a common procedure undertaken by individuals with low back pain caused by degeneration of the lumbar spine. (2)

It involves fusing two or more adjacent vertebra together to prevent instability of the joint and aims to reduce low back pain.

However, it is difficult to know if the low back pain can actually be attributed to the degeneration of the lumbar spine. Recent studies show that up to 90% of chronic lower back pain is non-specific, meaning it cannot be clearly linked to any structural pathology (1). This procedure also substantially limits the range of motion that the joint can have once it is fused.

Having a long-term exercise plan in place for managing low back pain can:

  • Reduce cost from surgery
  • Maintain or improve range of motion of the lumbar spine
  • Maintain or improve strength of the lumbar spine
  • Reduce the likelihood of future surgical intervention

Did you know that walking was found to be an effective exercise for improving pain, disability, quality of life, and fear-avoidance behaviour in those with chronic low back pain (3). Simply walking for 10 minutes every day can help relieve the symptoms of low back pain – as well as being good for your heart!

If you are ever deciding which route to go for chronic low back pain management, ensure you are well informed of all of the different treatment modalities and the advantages/disadvantages of each before you make a decision.

Be sure to book an appointment with one of our exercise physiologists or physiotherapists to discuss the management of your low back pain.

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References

1. Brox, J. I., Reikerås, O., Nygaard, Ø., Sørensen, R., Indahl, A., Holm, I., … & Friis, A. (2006). Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study. Pain122(1-2), 145-155.

2. Khor, S., Lavallee, D., Cizik, A. M., Bellabarba, C., Chapman, J. R., Howe, C. R., Lu, D., Mohit, A. A., Oskouian, R. J., Roh, J. R., Shonnard, N., Dagal, A., & Flum, D. R. (2018). Development and Validation of a Prediction Model for Pain and Functional Outcomes After Lumbar Spine Surgery. JAMA Surgery153(7), 634–642. https://doi.org/10.1001/jamasurg.2018.0072

3. Xu, W., Ran, B., Luo, W., Li, Z., & Gu, R. (2021). Is Lumbar Fusion Necessary for Chronic Low Back Pain Associated with Degenerative Disk Disease? A Meta-Analysis. World Neurosurgery146, 298–306. https://doi.org/10.1016/j.wneu.2020.11.121

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