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Eugene Carragee, MD

JAMA. 2006;296:2485-2487.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The benefit of surgical treatment for some diseases affecting the lumbar spine is not controversial in many clinical circumstances, such as major trauma with gross instability, unstable spondylolisthesis, persistent or complicated spinal infections, and some spinal tumors with progressive neurologic loss. More commonly a patient may contemplate surgical treatment for complications of common degenerative conditions affecting the lumbar disk. In general, 2 clinical syndromes are associated with these degenerative conditions, and the clinical course and efficacy of interventions for each is very different. The first is primary back pain with little or no component of radicular symptoms due to nerve root irritation. The second is primary radicular pain, which usually has some component of back pain.

Surgical treatment for primary back pain associated with disk changes ("discogenic pain") is the more controversial and less successful.^1-2 When examination of the lumbar spine reveals only common degenerative changes, the . . . [Full Text of this Article]

Author Affiliation: Stanford University Medical Center, Stanford, Calif.

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