Anatomic surgical management of chronic low back pain.
OBJECTIVE
To review spine surgery management strategies for patients with chronic low back pain (CLBP) that has failed to respond to all nonsurgical treatment options.


METHODS
Literature review was conducted for spine surgery in the treatment of CLBP without compressive anatomical disease. The main diagnosis identified was degenerated disc disease, and surgical options targeted for the treatment of CLBP were reviewed.


RESULTS
The history of current spine intervention for CLBP was reviewed, including various surgical options. Surgical treatment options for patients with CLBP include lumbar fusion, lumbar disc arthroplasty, and dynamic stabilization. Lumbar fusion remains the most frequent spine surgery performed for CLBP, but questions still exist regarding its efficacy in comparison with conservative care or interventional pain management. Lumbar disc arthroplasty and dynamic stabilization can both be considered only for select patients with CLBP, and their uses are currently limited.


CONCLUSIONS
Despite the number of spine surgeries that have been performed for CLBP, the surgical outcome still remains questionable. Until a precise identification of the cause of CLBP in any given patient can be precisely determined, surgical solutions will continue to be less than optimal.
Department of Neurosurgery, Stanford University, Stanford, CA, USA.
Bohdan
B
Chopko
John C
JC
Liu
Mohammad K
MK
Khan
D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D013131:Spine / Q000601:surgery*
Chronic low back pain; surgery