The DOI matches its Crossref record; 41 of the 43 references it cites were found in a registry or an index.
Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial
Open accessAbstract
OBJECTIVES: To assess the clinical effectiveness of surgical stabilisation (spinal fusion) compared with intensive rehabilitation for patients with chronic low back pain. DESIGN: Multicentre randomised controlled trial. SETTING: 15 secondary care orthopaedic and rehabilitation centres across the United Kingdom. PARTICIPANTS: 349 participants aged 18-55 with chronic low back pain of at least one year's duration who were considered candidates for spinal fusion. INTERVENTION: Lumbar spine fusion or an intensive rehabilitation programme based on principles of cognitive behaviour therapy. MAIN OUTCOME MEASURE: The primary outcomes were the Oswestry disability index and the shuttle walking test measured at baseline and two years after randomisation. The SF-36 instrument was used as a secondary outcome measure. RESULTS: 176 participants were assigned to surgery and 173 to rehabilitation. 284 (81%) provided follow-up data at 24 months. The mean Oswestry disability index changed favourably from 46.5 (SD 14.6) to 34.0 (SD 21.1) in the surgery group and from 44.8 (SD14.8) to 36.1 (SD 20.6) in the rehabilitation group. The estimated mean difference between the groups was -4.1 (95% confidence interval -8.1 to -0.1, P = 0.045) in favour of surgery. No significant differences between the treatment groups were observed in the shuttle walking test or any of the other outcome measures. CONCLUSIONS: Both groups reported reductions in disability during two years of follow-up, possibly unrelated to the interventions. The statistical difference between treatment groups in one of the two primary outcome measures was marginal and only just reached the predefined minimal clinical difference, and the potential risk and additional cost of surgery also need to be considered. No clear evidence emerged that primary spinal fusion surgery was any more beneficial than intensive rehabilitation.
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“Although trials do not tend to report adverse effects or deterioration (such as worsening of depression to a level of clinical concern), we know that such effects should be small (Fairbank 2005;Hellum 2011;Morley 2008), so the treatment can be considered to be safe, with the reservation that the reasons for discontinuing treatment are rarely given and may be due to hidden adverse effects.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Fairbank 2005
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“Treatment gains are of the same order as those of other available treatments (Glombiewski 2010), as shown by head-to-head trials of surgery versus psychologically based rehabilitation (Fairbank 2005;Hellum 2011).”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Fairbank 2005
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Citations
Cites
Fairbank, J. C. T., & Pynsent, P. B. (2000) · Spine · doi:10.1097/00007632-200011150-00017 · Cited by 5,851
Multiple Imputation of Missing Values
Royston, P. (2004) · The Stata Journal: Promoting communications on statistics and Stata · doi:10.1177/1536867x0400400301 · Cited by 2,340
The Roland–Morris Disability Questionnaire and the Oswestry Disability Questionnaire
Roland, M. O., & Fairbank, J. C. T. (2000) · Spine · doi:10.1097/00007632-200012150-00006 · Cited by 1,913
Competing interests: none declared.
Hirsch, L. (2006) · Cited by 1,396
United States Trends in Lumbar Fusion Surgery for Degenerative Conditions
Deyo, R. A., Gray, D. T., Kreuter, W., Mirza, S. K., & Martin, B. I. (2005) · Spine · doi:10.1097/01.brs.0000166503.37969.8a · Cited by 996
Multidisciplinary rehabilitation for chronic low back pain: systematic review
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- Nuffield Orthopaedic Centre, Oxford OX3 7LD Jeremy Fairbank consultant orthopaedic surgeon James Wilson-MacDonald consultant orthopaedic surgeon Karen Barker director of physiotherapy research University of Warwick, Division of Health in the Community, Coventry CV4 7AL Helen Frost research fellow Centre for Statistics in Medicine, Oxford OX3 7LF Ly-Mee Yu statistician Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford OX2 6HE Rory Collins professor Correspondence to: J Fairbank jeremy.fairbank@ndos.ox.ac.uk
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Items 501–513 of 513
Window, P., Bada, E., Stovell, M. G., Ahuja, S., Beard, D. J., Gardner, A. C., & Foster, N. E. (2025) · Global Spine Journal · doi:10.1177/21925682251323865
Zhu, Y. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Rejante, T. G. D., Ferraris, K. P., Alcazaren, J. C., Navarro, J. E., & Seng, K. (2026) · Cureus · doi:10.7759/cureus.102509
“In randomized controlled trials (RCTs) by Brox et al. [6], Fairbank et al. [7], and Mannion et al. [4], there were no statistically significant differences between treatment groups randomized to either lumbar fusion surgery or cognitive intervention and exercises.”
Caby, I. (2010) · doi:10.70675/f3a238c5z7f30z41c7z9853z805c6c9a9f6a
“Les experts soulignent l’absence de preuves scientifiques confirmant la supériorité de ces techniques par rapport aux traitements non invasifs (Brox et al. 2003; Fairbank et al. 2005; Burton 2006).”
BackgroundEffets biomécaniques des implants interépineux lombaires
Khiami, F. (2013) · theses.fr (ABES) · doi:10.70675/3485127az81b7z4584z8033z8b2710d05f9b
Nyström, B., Schillberg, B., Lundin, P., Stiles, T. C., & Jin, S. (2026) · Interdisciplinary Neurosurgery · doi:10.1016/j.inat.2026.102317
Age-Related Transitions in Low Back Pain Pathology: A Life-Course Narrative Review
Ikemoto, T., Hirasawa, A., & Wakao, N. (2026) · Pain and Therapy · doi:10.1007/s40122-026-00891-2
2026 - A landmark year for the Society of British Neurological Surgeons
Pollock, J., & GULLAN, R. W. (2026) · British Journal of Neurosurgery · doi:10.1080/02688697.2026.2733182
2026 - A landmark year for the Society of British Neurological Surgeons
Pollock, J., & Gullan, R. (2026) · British Journal of Neurosurgery · doi:10.1080/02688697.2026.2731723
“33 A randomised lumbar study suggested that transforaminal epidural steroid injection in sciatica secondary to herniated lumbar disc was as effective as surgery and attracted a lower incidence of adverse events.”
Residential vs non-residential pain management: a systematic review of patient outcomes
Watters, G. (2026) · International Journal for Advancing Practice · doi:10.12968/ijap.2025.0055
Metadata
- Authors
- Fairbank, J., Frost, H., Wilson-MacDonald, J., Yu, L.-M., Barker, K., & Collins, R.
- Affiliations
- Nuffield Orthopaedic Centre (GB)
- University of Warwick (GB)
- University of Oxford (GB)
- Corresponding author
- Fairbank, Jeremy
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2005-05-23
- Volume
- 330
- Issue
- 7502
- Pages
- 1233
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC558090
- OpenAlex
- W2117632584
- Cited by
- 514
- References
- 43
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 9 · 2023: 11 · 2022: 16 · 2021: 11 · 2020: 8 · 2019: 18 · 2018: 11 · 2017: 25 · 2016: 25 · 2015: 31 · 2014: 25 · 2013: 38 · 2012: 28
- FWCI
- 25.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by-nc)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, cc-by-nc)
- Research Output (Edinburgh Napier University) (submittedVersion, cc-by)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic low back pain, lumbar fusion, spinal stabilization, intensive rehabilitation, cognitive behavioral therapy, Oswestry Disability Index, disability, walking capacity, SF-36
- MeSH terms
- Adolescent, Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Patient Compliance, Spinal Fusion, Cognitive Behavioral Therapy, Treatment Outcome, Low Back Pain
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