title: Surgical treatment of low back pain.
abstract: There is a need for quality trials that study optimal selection and timing of surgical treatment options. Studies are needed of cost-effectiveness and effect on long-term improvement. Until data from such studies are available, primary physicians should follow the guidelines on conservative management and aggressively evaluate the red flags of low back pain, immediately refer for neurologic deficit and bowel or bladder compromise, and focus treatment on modalities with high-quality evidence-based information. Patients who do not improve can be referred to surgeons with experience and expertise in discectomies.
authors.affiliation: Clinical and Educational Services, Family Medicine Residency, Duke Southern Regional AHEC, 1601 Owens Drive, Fayetteville, NC 28304, USA. eron.manusov@sr-ahec.org
authors.forename: Eron G
authors.initials: EG
authors.lastname: Manusov
mesh_terms: D003362:Cost-Benefit Analysis; D017586:Diskectomy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D017116:Low Back Pain / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D011320:Primary Health Care; D013123:Spinal Fusion / Q000379:methods*