Year: 2014  Study type: Retrospective study   

Smith J, Sidhu G, Bode K, Gendelberg D, Maltenfort M, Ibrahimi D et al. Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease Have Similar Long-Term Clinical Outcomes Among Patients with Positive Discography. World Neurosurgery 2014;82(5):872-878.

Objective

To compare effects of fusion versus nonoperative treatment on patients with discography concordant lumbar degenerative disc disease. 

Methods

Retrospective review of patients referred to a diagnostic lumbar discography procedure between 2003 and 2009.

Patients (n=200) were offered spinal fusion and they either accepted (n=96) or declined (n=104) the surgical treatment. Follow-up (mean length 63 months) was obtained for 96 patients (53 operated, 43 non-operated). 

Outcome measures: Oswestry disability index (ODI), satisfaction scale and the short form 12 (SF-12) survey, pain (NRS).

Outcome

Fusion did not induce better long-term outcomes with regard to pain, health status, satisfaction, or disability compared to nonoperative treatment in patients with back pain and concordant discography. Both groups demonstrated significant improvements in pain scores ta follow-up compared to the baseline.