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

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

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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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A prospective randomized trial
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Self-citation

Authors: van Tulder, M. W., Koes, B., Seitsalo, S., & Malmivaara, A.
Affiliations: Erasmus MC (NL)
Tekonivelsairaala Orton (FI)
ORCID: Koes, Bart
Malmivaara, Antti
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: green
www.ncbi.nlm.nih.gov
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 › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

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