title: Surgical versus nonsurgical treatment of chronic low back pain: A meta-analysis based on current evidence.
abstract: BACKGROUND
  There are still no clearly defined clinical-practice guidelines related to surgical intervention for chronic low back pain (CLBP) in the absence of serious structural problems such as instability, spinal stenosis, spondylolysis, infection, or neoplasm. There is also a lack of high-quality evidence regarding CLBP treatment.
  
  
  OBJECTIVE
  To compare the clinical effectiveness of lumbar surgery vs. nonsurgical treatment for chronic low back pain.
  
  
  METHODS
  A search was conducted using MEDLINE®, Embase, and reference lists of articles and personal files. After a systematic search, studies were selected on the basis of inclusion criteria. Six articles (904 patients) met the inclusion criteria for the study. Pooled estimates of clinical results were calculated with 95% confidence intervals.
  
  
  RESULTS
  All six eligible studies were independent randomized clinical trials. Pooled data revealed that, compared with surgical treatment, nonsurgical treatment was associated with better Oswestry Disability Index scores. Both groups had similar Visual Analogue Scale and Emotional Distress Scale scores as well as General Function Scores.
  
  
  CONCLUSIONS
  For chronic low back pain, nonsurgical treatment was shown to be effective, feasible, and safe during the follow-up period. More randomized controlled trials are needed to compare surgical and nonsurgical treatment of chronic low back pain.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Qunfeng
authors.initials: Q
authors.lastname: Guo
authors.forename: Xuhua
authors.initials: X
authors.lastname: Lu
authors.forename: Bin
authors.initials: B
authors.lastname: Ni
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D004185:Disability Evaluation; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D062707:Return to Work; D064232:Visual Analog Scale
keywords: Chronic low back pain; Lumbar; Oswestry Disability Index; meta-analysis; nonsurgical treatment; surgical treatment