Chronic back pain: does elective surgery benefit patients with evidence of psychologic disturbance?

Thirty-five patients with chronic low back pain responded to a follow-up survey 18 months after being discharged from the hospital. All patients had objective (MMPI) evidence of psychologic disturbance during hospitalization. Seven patients subsequently obtained additional elective back surgery; the remaining 28 did not. Follow-up data indicated that patients who had operation were less likely to return to work during this period, were less likely to have reduction in their perceived pain, and were more likely to report increased disability than were those not operated on. These data suggest that elective surgery may, in fact, be counterproductive for patients with chronic low back pain and evidence of psychologic disturbance.