Back Pain Outcomes Similar for Surgery, Cognitive Intervention

Long-term outcomes similar for patients treated with surgery or cognitive intervention and exercise

FRIDAY, Sept. 23 (HealthDay News) -- 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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