The role of spinal surgery in the treatment of low back pain

. 2022 Dec 11;218(1):40–45. doi: 10.5694/mja2.51788

Study (year)	Number of patients	Follow‐up (months)	Intervention	Result	GRADE^*
Ohtori ³⁸ (2011)	41	24	Fusion v minimal treatment	VAS, JOAS, ODI significantly improved with surgery (P < 0.05)	Low
Brox ³⁹ (2006)	60	12	Fusion v cognitive + exercises	ODI no significant difference (P = 0.15)	Moderate
Fairbank ⁴⁰ (2005)	349	24	Fusion v intensive rehabilitation	ODI reduced 4.1 in favour of surgery (P = 0.045)	Moderate
Brox ⁴¹ (2003)	64	12	Fusion v cognitive + exercises	ODI reduced 2.3 (P = 0.33)	Moderate
Fritzell ⁴² (2003)	294	24	Fusion v physical therapy	VAS reduced in surgical group 33% v 7%; ODI 25% v 6%	Moderate

GRADE = Grading of Recommendations Assessment, Development and Evaluation; JOAS = Japanese Orthopaedic Association Score; ODI = Oswestry Disability Index; VAS = Visual Analogue Scale.

Low: the true effect might be markedly different from the estimated effect. Moderate: the authors believe that the true effect is probably close to the estimated effect.