Turner et al. (1992) conducted a systematic review of 47 articles (1966–1991) to determine whether lumbar spinal fusion improves outcomes over laminectomy alone, what complications occur, and what predicts success — in the complete absence of any randomized trial evidence.
Before recommending fusion, ensure the patient has a clear indication where fusion has proven superiority over less invasive options. This paper reminds us that more complex surgery isn't automatically better surgery.
Turner et al. (1992) conducted a systematic review of 47 articles (1966–1991) to determine whether lumbar spinal fusion improves outcomes over laminectomy alone, what complications occur, and what predicts success — in the complete absence of any randomized trial evidence.
Before recommending fusion, ensure the patient has a clear indication where fusion has proven superiority over less invasive options. This paper reminds us that more complex surgery isn't automatically better surgery.