[Indications and limitations of surgery of common low back pain].
Surgical treatment of the low-back pain remains controversial in term of efficacy. Surgical treatment is advocated only when conservative management fails, a clearly identifiable cause of lumbar pain is identified, worker's compensations are detected, psychological disorders are treated and disability and pain are still present. In addition, we used a preoperative external diagnostic immobilisation with hip spica cast to select the patients. Posterior instrumented fusion is more often used, however several studies demonstrated the interest of interbody fusion when an inflammatory signal of the disc was detected on the MRI. Spinal fusion provide 50-93% of clinical success in the literature, spondylolisthesis remains the better indication. Only 30% returning to work were obtained.
Anract
P
P
Service de chirurgie orthopédique du Pr B. Tomeno, Hôpital Cochin, Paris. philippe.anract@cch.ap-hop-paris.fr
D015299:Discitis / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery; D009784:Occupational Diseases / Q000601:surgery; D018579:Patient Selection; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000601:surgery; D016896:Treatment Outcome