Is surgery for back pain relief more effective than cognitive behavioral therapy and strengthening exercises for back pain? According to a recent study published in the August issue of The Spine Journal, the answer is no.

Here is an excerpt from this study published in the September 23rd edition of Physician’s Briefing.

Patients with chronic low back pain (CLBP) and disc degeneration who undergo either surgery or cognitive intervention and exercise have similar results for trunk muscle strength, cross-sectional area, and density at a seven- to 11-year follow-up, according to a study published in the August issue of The Spine Journal.

Anne Froholdt, M.D., from the Oslo University Hospital in Norway, and colleagues compared the long-term effect of lumbar fusion with cognitive intervention and exercise on trunk muscle strength, cross-sectional area, density, and self-rated function in patients with CLBP and disc degeneration. Patients underwent either instrumented posterolateral fusion of one or both of the two lower lumbar levels, or a three-week cognitive intervention and exercise program. The back extension (E) and flexion (F) muscles and E/F ratio were measured, and the cross-sectional area and density of the back muscles at the L3-L4 segment were determined. A total of 55 patients were included in a follow-up ranging between seven and 11 years.

The investigators found no significant differences between the groups in terms of cross-sectional area, density, muscle strength, or self-rated function. Significantly increased trunk muscle extension was found in the cognitive intervention and exercise group. Both groups scored significantly better on trunk muscle function tests at long-term follow up. Self-rated function improved by nearly 56 percent, cross-sectional area decreased by 8.5 percent, and muscle density decreased by 27 percent on average.

“Gross muscle strength, cross-sectional area, and density above the lesion are not different between those who have had lumbar fusion or cognitive intervention and exercises at seven to 11 years,” the authors write.

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