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Lumbar fusion did not differ from cognitive therapy plus exercise for reducing disability and pain in chronic low back pain

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 Q In patients with chronic low back pain (CLBP), is instrumented lumbar fusion (ILF) more effective than cognitive therapy plus exercise (CTE) for reducing CLBP related disability and pain?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Neurology ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

outcome assessors.*

Embedded ImageFollow up period:

1 year.

Embedded ImageSetting:

4 hospitals in Norway.

Embedded ImagePatients:

64 patients 25–60 years of age (mean age 43 y, 61% men) with CLBP that lasted >1 year who had Oswestry Disability Index (ODI) ⩾30 of 100 points, and degeneration at L4–L5 and/or L5–S1 (spondylosis) on plain radiographs. Exclusion criteria included widespread myofascial pain, spinal stenosis with reduced walking distance and neurological signs, and recurrent disc herniation or lateral recess stenosis …

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  • * See glossary.

  • For correspondence: Dr J I Brox, National Hospital, Oslo, Norway.

  • Sources of funding: Norwegian Federal Government and Health and Rehabilitation Foundation.

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