Age greater than 20 years and less than 65 years |
Back pain of greater than 6-month duration |
Has telephone and willing to complete telephone interviews |
Ability to communicate in English |
Physician diagnosis of discogenic back pain |
One or two level disc degeneration on MRI scan |
Exclusion Criteria: |
Leg pain greater than back pain |
Pregnant |
Instability on lumbar flexion-extension radiographs (if done) |
Motor deficit on physical examination |
Abnormal electrodiagnostic studies (if done) |
Lumbar spinal stenosis requiring a laminectomy. |
Prior lumbar fusion or multilevel laminectomy |
Spondylolisthesis of more than 25% (>grade I) |
Inflammatory spondyloarthropathy |
Spinal malignancy or infection |
Severe co-morbid illness that would contraindicate surgery or result in major functional decline |
Developmental spine deformities or vertebral fractures |
Disc protrusion or extrusion on imaging with either: |
Nerve root compression or displacement, or pain radiating below the knee |