[Chronic back pain--operative therapeutic options in chronic back pain]

The main challenge in the surgical treatment of chronic low back pain lies in the poor knowledge of its etiology. Surgery, however, requires the identification of a surgically curable lesion. In cases of radiologically obvious structural spinal disease like stenosis, instability or deformity, surgery is indicated after failure of conservative measures and achieves acceptable success rates. The vast majority of patients, however, demonstrates only unspecific segmental degeneration. Fusion is only somewhat effective and there is no evidence-based data for the abundant modern and less invasive techniques.