{"id":"https://openalex.org/W2062733836","doi":"https://doi.org/10.1016/j.pain.2006.01.028","title":"Spinal fusion or exercise and cognitive intervention? In search of the answers","display_name":"Spinal fusion or exercise and cognitive intervention? In search of the answers","publication_year":2006,"publication_date":"2006-03-10","ids":{"openalex":"https://openalex.org/W2062733836","doi":"https://doi.org/10.1016/j.pain.2006.01.028","mag":"2062733836","pmid":"https://pubmed.ncbi.nlm.nih.gov/16527401"},"language":"en","primary_location":{"id":"doi:10.1016/j.pain.2006.01.028","doi":"https://doi.org/10.1016/j.pain.2006.01.028","is_oa":false,"landing_page_url":"https://doi.org/10.1016/j.pain.2006.01.028","pdf_url":null,"source":{"id":"https://openalex.org/S140848990","display_name":"Pain","issn_l":"0304-3959","issn":["0304-3959","1872-6623"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","erih-plus","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain","raw_type":"journal-article"},"volume":null,"type":"editorial","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5071841919","display_name":"Rosemary C. Polomano","orcid":"https://orcid.org/0000-0001-5225-6081","observed_orcids":["https://orcid.org/0000-0001-5225-6081"]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Rosemary C. Polomano","raw_affiliation_strings":["Tel.: +1 215 898 0934","University of Pennsylvania, School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Tel.: +1 215 898 0934","institution_ids":[]},{"raw_affiliation_string":"University of Pennsylvania, School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049191390","display_name":"Paul J. Marcotte","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paul J. Marcotte","raw_affiliation_strings":["Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5085578019","display_name":"John T. Farrar","orcid":"https://orcid.org/0000-0001-8656-5157","observed_orcids":["https://orcid.org/0000-0001-8656-5157"]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John T. Farrar","raw_affiliation_strings":["Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5071841919"],"corresponding_institution_ids":["https://openalex.org/I79576946"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":6,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"122","issue":"1","first_page":"4","last_page":"5"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.7886000275611877,"subfield":{"id":"https://openalex.org/subfields/3612","display_name":"Physical Therapy, Sports Therapy and Rehabilitation"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.7886000275611877,"subfield":{"id":"https://openalex.org/subfields/3612","display_name":"Physical Therapy, Sports Therapy and Rehabilitation"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":0.2084999978542328,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11518","display_name":"Cervical and Thoracic Myelopathy","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/spinal-fusion","display_name":"spinal fusion","score":0.8840000033378601},{"id":"https://openalex.org/keywords/low-back-pain","display_name":"low back pain","score":0.8420000076293945},{"id":"https://openalex.org/keywords/exercise-therapy","display_name":"exercise therapy","score":0.640999972820282},{"id":"https://openalex.org/keywords/cognitive-intervention","display_name":"cognitive intervention","score":0.7409999966621399},{"id":"https://openalex.org/keywords/oswestry-disability-index","display_name":"Oswestry Disability Index","score":0.7940000295639038},{"id":"https://openalex.org/keywords/statistical-power","display_name":"statistical power","score":0.8370000123977661},{"id":"https://openalex.org/keywords/sample-size","display_name":"sample size","score":0.7350000143051147},{"id":"https://openalex.org/keywords/interpatient-variability","display_name":"interpatient variability","score":0.6349999904632568},{"id":"https://openalex.org/keywords/chronic-low-back-pain","display_name":"chronic low back pain","score":0.7070000171661377},{"id":"https://openalex.org/keywords/fear-avoidance-beliefs","display_name":"fear-avoidance beliefs","score":0.7549999952316284},{"id":"https://openalex.org/keywords/emotional-distress","display_name":"emotional distress","score":0.5199999809265137},{"id":"https://openalex.org/keywords/treatment-effectiveness-comparison","display_name":"treatment effectiveness comparison","score":0.41600000858306885},{"id":"https://openalex.org/keywords/workman-s-compensation","display_name":"workman's compensation","score":0.5090000033378601}],"concepts":[{"id":"https://openalex.org/C140556311","wikidata":"https://www.wikidata.org/wiki/Q214746","display_name":"Biostatistics","level":3,"score":0.6895032525062561},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.48882219195365906},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.4833652377128601},{"id":"https://openalex.org/C12770488","wikidata":"https://www.wikidata.org/wiki/Q188449","display_name":"Neurosurgery","level":2,"score":0.4735642671585083},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.412043958902359},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3722243905067444},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.20549637079238892},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.1508347988128662},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.137001633644104},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001416","descriptor_name":"Back Pain","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D001416","descriptor_name":"Back Pain","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D002908","descriptor_name":"Chronic Disease","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005081","descriptor_name":"Exercise Therapy","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007405","descriptor_name":"Intervertebral Disc Displacement","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D007405","descriptor_name":"Intervertebral Disc Displacement","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D008159","descriptor_name":"Lumbar Vertebrae","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009664","descriptor_name":"Norway","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D011379","descriptor_name":"Prognosis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012307","descriptor_name":"Risk Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013123","descriptor_name":"Spinal Fusion","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D013123","descriptor_name":"Spinal Fusion","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D015897","descriptor_name":"Comorbidity","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015928","descriptor_name":"Cognitive Behavioral Therapy","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D015994","descriptor_name":"Incidence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016032","descriptor_name":"Randomized Controlled Trials as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018570","descriptor_name":"Risk Assessment","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1016/j.pain.2006.01.028","doi":"https://doi.org/10.1016/j.pain.2006.01.028","is_oa":false,"landing_page_url":"https://doi.org/10.1016/j.pain.2006.01.028","pdf_url":null,"source":{"id":"https://openalex.org/S140848990","display_name":"Pain","issn_l":"0304-3959","issn":["0304-3959","1872-6623"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","erih-plus","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain","raw_type":"journal-article"},{"id":"pmid:16527401","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/16527401","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain","raw_type":"Comparative Study"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9391000270843506}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":7,"referenced_works":["https://openalex.org/W2019117036","https://openalex.org/W2089860017","https://openalex.org/W2102211861","https://openalex.org/W2111209536","https://openalex.org/W2117632584","https://openalex.org/W2142999803","https://openalex.org/W2399468652"],"related_works":["https://openalex.org/W2111209536","https://openalex.org/W2082567993","https://openalex.org/W2089860017","https://openalex.org/W2091302462","https://openalex.org/W2100390665","https://openalex.org/W2130199219","https://openalex.org/W2046002576","https://openalex.org/W4223412436","https://openalex.org/W2004120312","https://openalex.org/W2309472504"],"abstract_inverted_index":{"Brox":[0,301,380,515,924],"et":[1,282,302,342,381,516,536,887,918,925],"al.":[2,283,303,382,517,537,926],"(2006)":[3,518,927],"are":[4,433,810,821,1016],"to":[5,21,53,126,139,149,181,201,233,251,257,296,359,398,430,442,484,531,556,566,599,642,709,715,733,743,759,781,813,823,839,894,913,933,948,1011,1018,1033,1039,1057,1074,1079,1093,1106,1127,1131],"be":[6,147,194,208,439,510,728,787,796,972,979,1019,1104],"commended":[7],"for":[8,62,110,135,157,219,325,719,748,771,832,1041,1065,1081,1114,1170],"completing":[9],"a":[10,27,54,101,136,140,211,320,347,474,488,501,540,572,614,625,655,659,668,861,1022,1035],"well-designed":[11],"and":[12,23,48,245,328,375,409,423,505,576,806,864,904,907,974,987,1048,1097,1111,1173],"executed":[13],"investigation":[14,519,1083],"comparing":[15],"the":[16,38,67,72,84,90,93,111,118,124,128,143,153,159,168,171,175,185,191,220,234,241,262,269,272,309,314,354,399,443,452,462,465,468,482,496,552,578,584,589,593,643,647,662,677,684,688,692,697,739,745,749,760,764,785,798,851,856,870,876,923,940,944,949,953,967,982,995,1002,1082,1085,1115,1125],"effects":[17,878],"of":[18,32,92,99,103,107,113,152,163,170,184,187,236,264,271,311,316,350,377,394,448,455,477,551,592,613,646,654,661,667,679,741,763,766,800,808,859,879,984,1005,1024,1084,1145,1148,1159,1162,1176],"transpedicular":[19],"fusion":[20,604],"cognitive":[22,897,945],"exercise":[24,881,934],"interventions":[25,770,820,898,1010,1064],"in":[26,40,42,71,131,204,240,292,306,353,363,386,389,464,491,539,546,683,696,703,721,843,850,869,915,922,952,966,1014],"prospective,":[28],"randomized":[29],"clinical":[30,160,857],"trial":[31,469],"60":[33],"subjects.":[34],"The":[35,59,77,366,514,700,776,791,997],"study":[36,96,176,299,340,480,570,616,705,756,802,871,962],"evaluates":[37],"differences":[39,239,385,507],"effectiveness":[41,186],"disability,":[43],"general":[44,243],"function,":[45,244],"emotional":[46,246],"distress,":[47,247],"fear-avoidance":[49,842,884,901,954],"beliefs":[50],"from":[51,337,357,981,994,1095],"baseline":[52,358],"1":[55,360,522],"year":[56,361,574],"follow-up":[57,362],"assessment.":[58],"primary":[60,172,602],"endpoint":[61],"measuring":[63],"treatment":[64,112,165,238,412,533,622,635],"gains":[65],"was":[66,323,586,596,605,847],"change":[68,356],"over":[69,910],"time":[70],"Oswestry":[73],"Disability":[74],"Index":[75],"(ODI).":[76],"results":[78,192,786,1110],"show":[79,895],"no":[80],"significant":[81],"difference":[82,273,463,490,560,595],"between":[83,274,1108],"group":[85,317,594,657,686],"mean":[86,559],"ODI":[87,355,387,466,492,547],"scores":[88,388],"at":[89],"end":[91],"study.":[94,213,663],"This":[95,499,569,829],"is":[97,121,249,261,313,332,500,628,658,671,706,780,891,957,1031],"one":[98],"only":[100,487,521],"handful":[102],"randomized,":[104],"controlled":[105],"studies":[106,1076],"surgical":[108,141,411,549,685,767,827,1007,1063,1109],"procedures":[109],"low":[114,406,773,1050],"back":[115,407,460,774,1051,1118],"pain.":[116,378,775],"Although":[117],"sample":[119,368,475,670,701],"size":[120,144,270,476,591,702],"noteworthy":[122],"given":[123],"barriers":[125],"overcoming":[127],"numerous":[129],"challenges":[130],"successfully":[132],"recruiting":[133],"subjects":[134],"random":[137],"assignment":[138],"procedure,":[142],"may":[145,207,437,525,727],"not":[146,438,526,597,811,1056],"sufficient":[148],"answer":[150],"many":[151],"pressing":[154],"practice":[155,205,424],"questions":[156],"supporting":[158],"decision-making":[161],"process":[162],"considering":[164],"options.":[166],"Within":[167],"limits":[169],"outcome":[173],"finding,":[174],"represents":[177],"an":[178,293,297,338,619],"important":[179,250,1086],"contribution":[180,942,1004],"our":[182,217,1129],"knowledge":[183],"spinal":[188,603,1059],"fusion.":[189],"However,":[190,921],"must":[193],"cautiously":[195],"interpreted":[196],"as":[197,373,691,867],"these":[198,753,985,1096],"might":[199,254,638],"apply":[200],"possible":[202],"changes":[203,1013],"that":[206,222,276,345,436,467,581,601,629,652,672,681,694,729,778,797,804,896,943,960,1000,1028,1088],"suggested":[209],"by":[210,300,1021],"single":[212],"Nonetheless,":[214],"we":[215,458,630,650,673,937,1123],"express":[216],"enthusiasm":[218],"impact":[221],"this":[223,258,288,456,479,704,755,801,854,961],"research":[224,970,1030],"should":[225,971],"have":[226,255,278,471,527,639,874,1068,1124],"on":[227,334,370,495,882,1053],"future":[228,969],"investigations.":[229],"To":[230],"give":[231],"meaning":[232],"lack":[235],"overall":[237,950],"ODI,":[242],"it":[248,331,726],"understand":[252],"what":[253,637,782],"led":[256],"observation.":[259],"First":[260],"problem":[263,291],"statistical":[265],"power,":[266],"which":[267,426,524],"determines":[268],"groups":[275,445,930],"could":[277,470],"been":[279,528,1069],"detected.":[280,472],"Hagg":[281],"(2003,":[284],"2004)":[285],"pointed":[286],"out":[287,486],"very":[289,502],"same":[290,689],"editorial":[294],"response":[295],"earlier":[298,339],"(2003)":[304],"published":[305],"Spine.":[307],"Underlying":[308],"calculation":[310],"power":[312,321,483],"issue":[315,762],"variability.":[318],"While":[319],"analysis":[322],"reported":[324],"\u03b1":[326],"0.05":[327],"\u03b2":[329],"0.1,":[330],"based":[333],"pilot":[335,367],"data":[336,1126],"(Brox":[341],"al.,":[343,888,919],"1999)":[344],"estimates":[346],"standard":[348],"deviation":[349],"10":[351],"points":[352],"50":[364],"patients.":[365],"differs":[369],"characteristics":[371,690],"such":[372],"age":[374,391],"duration":[376],"Recently,":[379],"(2005)":[383],"found":[384,544],"various":[390],"groups.":[392],"Duration":[393],"pain":[395,408,805,911,1052],"also":[396,434,899,1103],"adds":[397],"inter-patient":[400],"variability":[401],"among":[402],"patients":[403,680,834,1043,1132],"with":[404,446,617,738,1044],"chronic":[405,772,1049],"prior":[410],"failures.":[413],"Pain":[414],"distribution,":[415],"psychological":[416],"disposition,":[417],"disability":[418,809,916],"status":[419],"(e.g.,":[420],"workman's":[421],"compensation),":[422],"variations,":[425],"aren't":[427],"always":[428],"easy":[429],"account":[431],"for,":[432],"confounders":[435],"equally":[440],"allocated":[441],"two":[444],"randomization":[447],"small":[449,590,708],"samples.":[450],"Given":[451],"non-inferiority":[453,615],"design":[454],"trial,":[457],"can":[459,784,978,990],"calculate":[461],"For":[473],"30,":[478],"had":[481,571],"rule":[485],"50%":[489],"score,":[493],"depending":[494],"variance":[497],"selected.":[498],"large":[503,1077],"difference,":[504],"smaller":[506],"would":[508,795],"probably":[509],"considered":[511],"clinically":[512],"important.":[513],"lasted":[520],"year,":[523],"long":[529],"enough":[530,598,1078],"observe":[532],"effects.":[534],"Fairbank":[535],"(2005),":[538],"much":[541,965],"larger":[542],"study,":[543,928],"improvements":[545],"favoring":[548],"stabilization":[550],"lumbar":[553],"spine":[554],"compared":[555],"intensive":[557,609,818],"rehabilitation,":[558],"\u22124.1":[561],"(95%":[562],"confidence":[563],"interval":[564],"\u22128.1":[565],"\u22120.1;":[567],"p=0.045).":[568],"2":[573],"follow-up,":[575],"still":[577],"authors":[579,998],"concluded":[580],"even":[582],"though":[583],"result":[585],"statistically":[587],"significant,":[588],"presume":[600],"any":[606,1006,1012],"better":[607,849],"than":[608],"rehabilitation.":[610],"Another":[611],"aspect":[612],"neither":[618],"active":[620],"(effective)":[621],"control":[623,627,656,909],"nor":[624],"no-treatment":[626],"cannot":[631,674,938],"know":[632,675],"if":[633,676,815],"either":[634],"exceeded":[636],"occurred":[640],"due":[641],"natural":[644],"history":[645],"disease.":[648],"Thus,":[649],"concur":[651],"absence":[653],"limitation":[660],"A":[664],"final":[665],"feature":[666],"limited":[669],"subgroup":[678,693,712],"improved":[682,695],"has":[687,830],"non-surgical":[698,769,1009],"group.":[699,723],"too":[707],"validly":[710],"conduct":[711],"analyses":[713],"or":[714,1008,1055],"develop":[716],"prediction":[717],"models":[718],"responders":[720],"each":[722,734],"As":[724],"such,":[725],"different":[730],"subgroups":[731],"responded":[732],"therapy,":[735],"leaving":[736],"us":[737,964],"question":[740,777,959],"how":[742],"identify":[744,1089],"right":[746,750],"patient":[747],"therapy.":[751],"Despite":[752],"shortcomings,":[754],"contributes":[757],"evidence":[758],"controversial":[761],"value":[765],"versus":[768],"remains":[779],"degree":[783],"translated":[788],"into":[789],"practice?":[790],"most":[792],"parsimonious":[793],"conclusion":[794],"findings":[799],"indicate":[803],"level":[807],"likely":[812,1017,1092],"worsen":[814],"alternative":[816],"structured":[817],"cognitive/exercise":[819,852],"attempted":[822],"avoid":[824],"more":[825,862,1029,1091],"aggressive":[826,863],"interventions.":[828],"implications":[831],"informing":[833],"about":[835,902],"acceptable":[836],"therapeutic":[837],"alternatives":[838],"surgery.":[840],"Because":[841],"performing":[844],"physical":[845,905],"activity":[846],"significantly":[848],"group,":[853],"underscores":[855],"benefit":[858,1094],"pursuing":[860],"consistent":[865],"approach":[866,1038],"prescribed":[868],"procedures.":[872],"Others":[873],"demonstrated":[875],"beneficial":[877],"short-term":[880],"high":[883],"(Klaber":[885],"Moffett":[886],"2004).":[889,920],"There":[890,956],"encouraging":[892],"work":[893,903],"lessen":[900],"activity,":[906],"gaining":[908],"leads":[912],"reductions":[914],"(Woby":[917],"both":[929],"were":[931],"exposed":[932],"programs":[935],"so":[936],"disentangle":[939],"relative":[941],"intervention":[946],"made":[947],"improvement":[951],"outcome.":[955],"little":[958],"offers":[963],"way":[968],"designed":[973],"conducted.":[975],"Valuable":[976],"insights":[977],"gleaned":[980],"experiences":[983],"investigators,":[986],"particularly,":[988],"readers":[989],"draw":[991],"meaningful":[992],"conclusions":[993],"discussion.":[996],"acknowledge":[999],"determining":[1001],"specific":[1003],"outcomes":[1015],"determined":[1020],"multitude":[1023],"factors.":[1025],"We":[1026,1071],"agree":[1027],"needed":[1032],"provide":[1034],"rational,":[1036],"scientific":[1037],"care":[1040],"advising":[1042],"degenerative":[1045],"disc":[1046,1066],"disease":[1047],"whether":[1054],"undergo":[1058],"fusions":[1060],"when":[1061],"previous":[1062],"herniation":[1067],"unsuccessful.":[1070],"encourage":[1072],"investigators":[1073],"pursue":[1075],"allow":[1080],"features":[1087],"populations":[1090],"possibly":[1098],"other":[1099,1112],"therapies.":[1100],"It":[1101],"will":[1102,1122],"necessary":[1105],"distinguish":[1107],"methods":[1113],"treating":[1116],"failed":[1117],"syndrome.":[1119],"Only":[1120],"then":[1121],"make":[1128],"advice":[1130],"truly":[1133],"evidence-based.":[1134],"Rosemary":[1135],"C.":[1136],"Polomano":[1137],"Paul":[1138],"J.":[1139],"Marcotte":[1140],"John":[1141],"T.":[1142],"Farrar":[1143],"1University":[1144],"Pennsylvania,":[1146,1163,1177],"School":[1147],"Nursing,":[1149],"420":[1150],"Guardian":[1151],"Drive,":[1152],"Philadelphia,":[1153,1164,1178],"PA":[1154,1165,1179],"19104,":[1155,1166,1180],"United":[1156,1167,1181],"States":[1157,1168,1182],"2Department":[1158],"Neurosurgery,":[1160],"University":[1161,1175],"3Center":[1169],"Clinical":[1171],"Epidemiology":[1172],"Biostatistics,":[1174],"*Tel.:":[1183],"+1":[1184],"215":[1185],"898":[1186],"0934.":[1187],"E-mail":[1188],"address:[email":[1189],"protected]":[1190]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2016,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}
