Letter to the editor regarding Mannion, Brox, Fairbank. Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: Long-term follow-up of three randomized controlled trials.

摘要

We have, with interest, read in this journal the recently published article "Comparison of spinal fusion and nonop-erative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials" by Mannion, Brox, and Fairbank. We are convinced that the conclusions drawn in the article are based on a partial misunderstanding or misinterpretation of the material. In the conservative group, 40% of the patients did cross over to surgical treatment. It seems justified to expect that patients who crossed over to surgery were failures from the conservative treatment, but in the analysis of the material, the authors have not regarded this large group of failures when analyzing the ITT (intention to treat) results in the conservative group.