The Lowdown on Low Back Pain
(and Other Aches)


My doctor says I need a back fusion. Should I get a second opinion?

Lumbar fusions are increasingly performed for chronic low back pain. A recent study from California showed a 40 percent increase in the rate of lumbar fusions done over the past five years. An increase in the number of surgeries was noted in all patient populations, including the very young and the elderly. The same study showed that the risks were high. Four patients in every thousand died as the result of surgery. Complication rates as high as 20 to 40 percent have been described by other studies. The most frequent complications are “non-union” (failure of the fusion to become solid) and ongoing pain (failure of the fusion to relieve discomfort).

Lumbar fusions are, however, effective if done properly. A recent study in the journal Spine showed excellent results in patients followed for ten years after surgery. The study showed that patients who were properly selected and received quality care, had good long term pain control and rarely required additional surgery.

Surgeons who do more fusions typically have lower complication rates. Shorter operative times may also correlate with less risk.

Ask your surgeon about his results. And, yes, common sense would dictate that you should consider a second opinion.



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Last modified: 07/27/08