1999
DOI: 10.2106/00004623-199906000-00002
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Relationship Between Rates and Outcomes of Operative Treatment for Lumbar Disc Herniation and Spinal Stenosis

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Cited by 95 publications
(43 citation statements)
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“…Conversely, where surgery rates were the lowest, patients had the most severe preoperative disease and the best postoperative outcomes (36). These findings support the notion that some back surgery is unnecessary and may lead to poor patient outcomes.…”
Section: Spinal Mrisupporting
confidence: 62%
“…Conversely, where surgery rates were the lowest, patients had the most severe preoperative disease and the best postoperative outcomes (36). These findings support the notion that some back surgery is unnecessary and may lead to poor patient outcomes.…”
Section: Spinal Mrisupporting
confidence: 62%
“…LF presents high practice variation both at the national and international levels (Cherkin et al 1994). One concern is that the outcome in general will be poorer the higher the rate of LF, since this has been shown to be the case for lumbar disc herniation and spinal stenosis surgery (Keller 1999). Another important point of concern is the indication for surgery, because many of these patients suffer significant psychosocial disturbances (Mendelson 1984, Nachemson 1999, Rush et al 2000.…”
mentioning
confidence: 99%
“…By each of the outcomes measured (Roland Disability Score, satisfaction with surgical outcome, and rates of disability compensation) the best results occurred in areas with the lowest surgery rates and the worse outcomes occurred in areas with the highest surgical rates. The region with intermediate surgical rates had intermediate outcomes on each measure (Table 1) [11]. Although we cannot comment on outcomes for the patients who did not undergo surgery, these results suggest that higher rates of surgery did not necessarily lead to better outcomes.…”
Section: Surgical Outcomesmentioning
confidence: 89%