Consensus at last! Long-term results of all randomized controlled trials show that fusion is no better than non-operative care in improving pain and disability in chronic low back pain
Four pages on PainSci cite Mannion 2016: 1. The Complete Guide to Low Back Pain 2. Complete Guide to Plantar Fasciitis 3. Spinal Fracture Bracing and Fixation
PainSci commentary on Mannion 2016: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Excellent and important commentary on Hedlund et al, which was an important long-term experiment comparing spinal fusion to physiotherapy over more than a decade. It seemed to produce a contradictory result that “prevents a strong conclusion.” But the waffling wasn’t necessary. That good-news-bad-news conclusion was a bit of an illusion. The authors cherry-picked the best possible sounding news from their own data, creating the appearance of uncertainty about spinal fusion where in fact there was none. Mannion, Brox, and Fairbank explain exactly why.
For full details, see Long term results of spinal fusion: good news and bad?
related content
- “Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials,” Mannion et al, Spine J, 2013.
- “The long-term outcome of lumbar fusion in the Swedish lumbar spine study,” Hedlund et al, The Spine Journal, 2016.
Specifically regarding Mannion 2016:
- Long term results of spinal fusion: good news and bad? — The results of the long-term Swedish lumbar spine study seemed mixed at first, but are probably just negative
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.