Improving the Effectiveness and Efficacy of Medical Care for Low Back Pain: ABack Pain Outcome Assessment Team. Abstract, Executive Summary, Final Report and Bibliography of Articles in the Medical Press

摘要

Back pain is a leading reason for physician visits, hospitalization, and workdisability. This PORT's goals were to study geographic variations and outcomes of back surgery; evaluate the reasons for non-surgical hospitalizations; examine the accuracy and optimal sequencing of expensive diagnostic tests; and disseminate information to clinicians and patients to improve the process of care. The research team has documented wide geographic variations in rates of back surgery, at the international, national, and state levels. We have also identified important variations in surgical outcomes according to patient age, diagnosis, and type of surgical procedure. In particular, operations involving spinal fusion appear to be associated with higher short-term complication rates and costs, and long-term benefits remain unclear. Non-surgical hospitalizations declined dramatically over the past decade, while rates of back surgery have continued to rise. Sophisticated imaging tests such as computed tomography and magnetic resonance imaging appear to be at least as accurate as more invasive testing with myelography.