A visiting US expert has warned people with lower back pain that is mainly disc-related to avoid having an operation called “lumbar fusion” because it doesn’t relieve chronic pain and leaves many people permanently disabled.
“I’m talking about fusion for degenerative disc disease and chronic low back pain,” says Dr Gary Franklin, a neurologist and medical director of the Washington State Department of Labor and Industries. “I’m not talking about other kinds of spinal surgery for conditions such as scoliosis, or severe spinal stenosis with neurological impairment, or a measurably unstable spine.” Dr Franklin said that, in two separate studies over 15 years of workers in Washington State who had fusion surgery for lower back problems, “Two years later, two thirds are so totally disabled that they cannot work in any occupation, and 10 years later 44 per cent are permanently disabled.
Lumbar fusion involves fusing, or joining, one vertebra to an adjacent vertebra or to the sacrum, a triangular bone in the lower back. “The evidence of lumbar fusion for lower back pain is that it doesn’t relieve chronic pain; that it does cause harm; and that it’s way more expensive than other treatments,” Dr Franklin says. “If the outcomes are this bad, why are we doing it? Mainly, because a lot of doctors believe their own theories.”
According to an article in the Medical Journal of Australia earlier this year, a study of workers’ compensation patients in NSW concluded that the outcomes were so poor that spinal fusions were not recommended for this group. The MJA article said independent reviews had found that as many as 40 per cent of those patients had persistent postoperative pain, and called for spinal surgeons to do a national audit of patient-centred outcomes for the procedure.
If you become aware of anyone who is recommended to have this procedure, recommend they get a second opinion.