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Three Part Question

[In patients presenting with simple, non-neurological chronic back pain] is [spinal fusion better than conservative] at [reducing pain and facilitating a return to normal activities]

Clinical Scenario

A 45 year old patient presents with a 2 year history of low back pain. He has had to give up his job as a sign painter as a result of his problem which has resulted in siginificant financial problems for him and his family. He describes no red flag symptoms and has no specific neurological signs. He has been previously investigated with plain X-rays and MR scan which have revealed degenerative disease of the lumbar spine. He wants to know if surgery is an option for the relief of his pain.

Search Strategy

Cochrane database of systematic reviews 2005 Edition 2.
Medline 2004 to May 2005. OVID interface via ATHENS
Cochrane
Spinal and fusion
Medline
[back pain.mp. or exp Back Pain/ or exp Back Pain/ or exp Low Back Pain/ or lumbar pain.mp.] and [fusion.mp.] limit to humans and english language and abstracts