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Cited by 124Spine and Intervertebral Disc PathologyMusculoskeletal pain and rehabilitationPain Management and Treatment

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

Open access
van Tulder, Maurits W., Koes, Bart, Seitsalo, Seppo, Malmivaara, Antti·2006·European Spine Journal
DOI 10.1007/s00586-005-1049-5PMC PMC3454546
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Abstract

Within the framework of evidence-based medicine high-quality randomised trials and systematic reviews are considered a necessary prerequisite for progress in orthopaedics. This paper summarises the currently available evidence on surgical and other invasive procedures for low back pain. Results of systematic reviews conducted within the framework of the Cochrane Back Review Group were used. Data were gathered from the latest Cochrane Database of Systematic Reviews 2005, Issue 2. The Cochrane reviews were updated using the evidence summary on surgery and other invasive procedures from the COST B13 European Guidelines for the Management of Acute and Chronic Non-Specific Low Back Pain. Facet joint, epidural, trigger point and sclerosant injections have not clearly been shown to be effective and can consequently not be recommended. There is no scientific evidence on the effectiveness of spinal stenosis surgery. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapses that fail to resolve with the conservative management. Cognitive intervention Combined with exercises is recommended for chronic low back pain, and fusion surgery may be considered only in carefully selected patients after active rehabilitation programmes during 2 years time have failed. Demanding surgical fusion techniques are not better than the traditional posterolateral fusion without internal fixation.

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Authors
van Tulder, M. W., Koes, B., Seitsalo, S., & Malmivaara, A.
Affiliations
  • Erasmus MC (NL)
  • Tekonivelsairaala Orton (FI)
ORCID
Venue
European Spine Journal
Publisher
Springer Science and Business Media LLC
Published
2005-12-01
Volume
15
Issue
S1
Pages
S82-S92
ISSN
  • 0940-6719 (ISSN-L)
  • 1432-0932
DOI
10.1007/s00586-005-1049-5
PMC
PMC3454546
OpenAlex
W2095078135
Cited by
124
References
112
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 1 · 2017: 13 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 9 · 2012: 7
FWCI
7.62
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • European Spine Journal (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
low back pain, sciatica, invasive treatment, spinal surgery, epidural injection, facet joint injection, trigger point injection, sclerosant injection, spinal stenosis surgery, discectomy, lumbar disc herniation, cognitive intervention, physical activity, spinal fusion, posterolateral fusion, rehabilitation
MeSH terms
Radiofrequency Therapy, Humans, Injections, Spinal, Intervertebral Disc Displacement, Sciatica, Spinal Osteophytosis, Outcome Assessment, Health Care, Low Back Pain

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