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Related Experiment Video

Updated: Jun 13, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
04:19

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

Published on: November 8, 2024

Debating the value of spine surgery.

Edward N Hanley1, Harry N Herkowitz, John S Kirkpatrick

  • 1Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC 28232, USA. edward.hanley@carolinashealthcare.org

The Journal of Bone and Joint Surgery. American Volume
|May 5, 2010
PubMed
Summary

Most spine surgeons doubt disc degeneration causes low back pain and prefer non-surgical treatments for themselves, despite the common use of lumbar arthrodesis and emerging disc replacement options.

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Area of Science:

  • Orthopedics
  • Spine Surgery
  • Pain Management

Background:

  • Lumbar arthrodesis is a standard surgical treatment for low back pain.
  • Total disc arthroplasty (lumbar disc replacement) is a newer, debated alternative.
  • The efficacy and cost-effectiveness of surgical interventions for low back pain remain controversial.

Purpose of the Study:

  • To assess spine surgeons' perspectives on the causes and preferred treatments for low back pain.
  • To gauge surgeon opinions on insurance coverage for lumbar disc replacement.
  • To understand surgeon treatment preferences in a hypothetical chronic low back pain scenario.

Main Methods:

  • A survey was conducted among orthopedic surgeons at the 2009 Annual Meeting of the AOA.
  • Participants were asked about the primary cause of low back pain and their hypothetical treatment choices.

Related Experiment Videos

Last Updated: Jun 13, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
04:19

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

Published on: November 8, 2024

  • Surgeon opinions on insurance coverage for disc replacement were also collected.

    • Main Results:

    • A majority of surveyed surgeons believed meaningful functional improvement from back pain surgery is debatable.
    • Most surgeons (61%) would opt for nonoperative treatment if experiencing chronic low back pain with degenerative changes.
    • Only a small fraction (23%) believed disc degeneration is the primary cause of low back pain, and very few would choose fusion or disc replacement for themselves.

    Conclusions:

    • There is significant skepticism among spine surgeons regarding the primary cause and optimal surgical treatment for low back pain.
    • Nonoperative management is the preferred hypothetical treatment choice for most surgeons experiencing degenerative disc disease.
    • Current evidence and surgeon sentiment suggest limited support for widespread adoption and insurance coverage of lumbar disc replacement.