Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration

Objectives. To compare the effectiveness of lumbar instrumented fusion with cognitive intervention and ex-ercises in patients with chronic low back pain and disc degeneration. Summary of Background Data. To the authors ’ best knowledge, only one randomized study has evaluated the effectiveness of lumbar fusion. The Swedish Lumbar Spine Study reported that lumbar fusion was better than continu-ing physiotherapy and care by the family physician. Patients and Methods. Sixty-four patients aged 25–60 years with low back pain lasting longer than 1 year and evidence of disc degeneration at L4–L5 and/or L5–S1 at radiographic examination were randomized to either lum-bar fusion with posterior transpedicular screws and post-operative physiotherapy, or cognitive intervention an