The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization.
STUDY DESIGN: A review of the surgical costs and results in a group of patients randomly allocated to surgery as part of a large prospective randomized trial of patients with chronic back pain. OBJECTIVE: To report the observational data from the surgical arm of a randomized trial comparing surgery...
| Egile Nagusiak: | , , , , , , |
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| Formatua: | Journal article |
| Hizkuntza: | English |
| Argitaratua: |
2008
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| _version_ | 1826260736855244800 |
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| author | Wilson-MacDonald, J Fairbank, J Frost, H Yu, L Barker, K Collins, R Campbell, H |
| author_facet | Wilson-MacDonald, J Fairbank, J Frost, H Yu, L Barker, K Collins, R Campbell, H |
| author_sort | Wilson-MacDonald, J |
| collection | OXFORD |
| description | STUDY DESIGN: A review of the surgical costs and results in a group of patients randomly allocated to surgery as part of a large prospective randomized trial of patients with chronic back pain. OBJECTIVE: To report the observational data from the surgical arm of a randomized trial comparing surgery with intensive rehabilitation for chronic low back pain. Clinical and economic data are reported. SUMMARY OF BACKGROUND DATA: Surgery for chronic low back pain is a well established but unproven intervention. The most cost-effective technique for spinal stabilization is still not established. METHODS: One hundred six patients with chronic low back pain were randomized to the surgical group of a randomized trial comparing spinal fusion of the lumbar with a 3 week intensive rehabilitation program. The primary outcomes were the Oswestry Disability Index (ODI) and the Shuttle Walking Test measured at baseline and 2 years postrandomization. Patients were stratified by preoperative diagnosis, smoking habit, and litigation. Complications were assessed and costs analyzed. RESULTS: Of the 176 surgical patients, 56 underwent postero-lateral fusion, 57 underwent interbody fusion, and 24 underwent flexible stabilization of the spine. The mean ODI for all patients in the surgical arm of the trial improved from a baseline of 46.5 (SD 14.6) to 34.2 (SD 21) at 2 years. Health care costs were higher ( 3109 pounds difference) for more complex procedures, and nearly 6 times as many early complications occurred with the more complex procedures. Smoking and unemployment were associated with worse results whereas litigation did not adversely affect the outcome. CONCLUSION: These observational changes in the ODI after surgery are similar to those reported from other studies of spinal fusion. More complex surgery is more expensive with more complications than postero-lateral fusion. |
| first_indexed | 2024-03-06T19:10:26Z |
| format | Journal article |
| id | oxford-uuid:16975463-5915-4bdd-9c1c-847528d05ff4 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:10:26Z |
| publishDate | 2008 |
| record_format | dspace |
| spelling | oxford-uuid:16975463-5915-4bdd-9c1c-847528d05ff42022-03-26T10:32:07ZThe MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:16975463-5915-4bdd-9c1c-847528d05ff4EnglishSymplectic Elements at Oxford2008Wilson-MacDonald, JFairbank, JFrost, HYu, LBarker, KCollins, RCampbell, H STUDY DESIGN: A review of the surgical costs and results in a group of patients randomly allocated to surgery as part of a large prospective randomized trial of patients with chronic back pain. OBJECTIVE: To report the observational data from the surgical arm of a randomized trial comparing surgery with intensive rehabilitation for chronic low back pain. Clinical and economic data are reported. SUMMARY OF BACKGROUND DATA: Surgery for chronic low back pain is a well established but unproven intervention. The most cost-effective technique for spinal stabilization is still not established. METHODS: One hundred six patients with chronic low back pain were randomized to the surgical group of a randomized trial comparing spinal fusion of the lumbar with a 3 week intensive rehabilitation program. The primary outcomes were the Oswestry Disability Index (ODI) and the Shuttle Walking Test measured at baseline and 2 years postrandomization. Patients were stratified by preoperative diagnosis, smoking habit, and litigation. Complications were assessed and costs analyzed. RESULTS: Of the 176 surgical patients, 56 underwent postero-lateral fusion, 57 underwent interbody fusion, and 24 underwent flexible stabilization of the spine. The mean ODI for all patients in the surgical arm of the trial improved from a baseline of 46.5 (SD 14.6) to 34.2 (SD 21) at 2 years. Health care costs were higher ( 3109 pounds difference) for more complex procedures, and nearly 6 times as many early complications occurred with the more complex procedures. Smoking and unemployment were associated with worse results whereas litigation did not adversely affect the outcome. CONCLUSION: These observational changes in the ODI after surgery are similar to those reported from other studies of spinal fusion. More complex surgery is more expensive with more complications than postero-lateral fusion. |
| spellingShingle | Wilson-MacDonald, J Fairbank, J Frost, H Yu, L Barker, K Collins, R Campbell, H The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title | The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title_full | The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title_fullStr | The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title_full_unstemmed | The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title_short | The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization. |
| title_sort | mrc spine stabilization trial surgical methods outcomes costs and complications of surgical stabilization |
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