Atkinson and Zacest1 stated that chronic low back pain is reaching epidemic proportions for a variety of medical, psychosocial and work-related problems. The direct and indirect economic cost in Australia has been modelled at $9.17 billion.2 The provision of surgery for non-specific low back pain (NSLBP) has the potential to significantly increase these costs, particularly under the economic cloak of “work cover”. A review of chronic low back pain pointed out that only 15% of cases may be due to significant intervertebral disc prolapse with neural compromise.3 The remaining cases were placed under the umbrella of NSLBP, which is a negative description of the failure to reach a diagnosis.
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- 1. Atkinson L, Zacest A. Surgical management of low back pain. Med J Aust 2016; 204: 299-300. <MJA full text>
- 2. Walker BF, Muller R, Grant WD. Low back pain in Australian adults: the economic burden. Asia Pac J Public Health 2003; 15: 79-87.
- 3. Andersson GB. Epidemiological features of chronic lower back pain. Lancet 1999; 354: 581-585.
- 4. Cusi M, Saunders J, Van der Wall H, Fogelman I. Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence. Eur Spine J 2013; 22: 1674-1682.
- 5. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934; 211: 210-215.
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