Avoiding surgery
pain
STILL, PRESSURE AREA
Despite the growing body of evidence that supports combining exercise therapy and psychosocial interventions for managing CNSLBP, many patients still undergo spinal fusion surgery instead of joining a multidisciplinary program. Guidelines recommend the cautious use of medication, imaging, and surgery. Still, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriate overuse of imaging, rest, opioids, spinal injections, and surgery [Additionally, multidisciplinary pain interventions have been reported more cost-effective than non-multidisciplinary ones, in terms of Quality-Adjusted Life Years [Overcoming the logistical issues when coordinating a multidisciplinary approach, changing patients’ mindset to “treating themselves” instead of “being treated”, and dodging the prosthetic industry pressure are challenging but achievable steps to implement this program. In our study, 1/4 (25%) patients offered a surgical approach utterly refused it after the study ended. Despite our small sample size, we expect the continuing implementation of multidisciplinary programs to reduce the number of spinal surgeries performed. However, larger clinical trials are needed to support this expectation.