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FOCUS ON RESEARCH Previous Volume 356:2239-2243 May 31, 2007 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Back surgery is not the final common pathway for everyone with persistent back pain. It offers specific therapy for specific anatomical derangements associated with specific complexes of symptoms. When surgery ranges beyond carefully defined situations, we can expect disappointed patients.

A generation ago, "back surgery" usually meant removing the offending portion of a herniated disk (Figure 1). Times have changed, and both the indications and the surgical techniques have expanded enormously. Indeed, clinical science has struggled to keep pace with innovation, creating uncertainties about the efficacy and safety of some new surgical techniques. Patients and primary physicians now . . . [Full Text of this Article]

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Dr. Deyo is a professor in the Departments of Medicine and Health Services and the codirector of the Center for Cost and Outcomes Research, University of Washington, Seattle.

An animated illustration showing spinal diskectomy and fusion (produced with assistance from James N. Weinstein, D.O., Dartmouth Medical School) can be viewed at www.nejm.org.

Related Letters:

Surgical versus Nonsurgical Treatment for Back Pain
da Costa B. R., Johnston B. C., Copeland B., Weinstein J. N., Lurie J. D., Tosteson T. D., Deyo R. A.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:1255-1256, Sep 20, 2007. Correspondence

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