Evidence-based spine surgery.
METHODS
Literature review.


OBJECTIVE
To describe the state of the literature regarding the performance of lumbar fusion for low back pain due to degenerative disease of the spine.


BACKGROUND
The effectiveness and costs associated with spinal surgery have been a topic of significant debate in both the popular press and professional literature.


METHODS
Evidence-based medicine techniques have been applied to many areas of spinal surgery. The results of these analyses are being used by practicing physicians, payors, and others to determine what procedures are appropriate for certain patient populations.


RESULTS
This manuscript describes the methodology, strengths, and weaknesses of evidence-based medicine approaches to spinal surgery. The case for lumbar fusion as a treatment for chronic low back pain due to degenerative disc disease is described as an example.


CONCLUSIONS
Evidence-based medicine is a useful tool for summarizing and grading the evidence available in the literature for or against a particular treatment strategy. Its utility is limited by the quality of the primary literature, and the absence of proof cannot be equated with the proof of absence.
Resnick
Daniel K
DK
Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA. Resnick@neurosurg.wisc.edu
D019317:Evidence-Based Medicine / Q000191:economics / Q000379:methods*; D006801:Humans; D019637:Orthopedic Procedures / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000191:economics / Q000379:methods; D013122:Spinal Diseases / Q000191:economics / Q000601:surgery*