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BMJ 2005;330 (28 May), doi:10.1136/bmj.330.7502.0-a
Surgical stabilisation of the spine for treating chronic low back pain is not cost effective when compared with an intensive rehabilitation programme from the perspective of health providers and patients. In a cost utility analysis based on a randomised controlled trial, Rivero-Arias and colleagues (p 1239) found that the estimated mean total cost per patient was £7830 in the surgery group and £4526 in the rehabilitation group, with the mean quality adjustment life years 1.004 and 0.936 respectively. The authors warn, however, that surgery could become cost effective if, for example, the proportion of rehabilitation patients who subsequently have surgery continues to increase.
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