In March, 2003, the Spine Section of the AANS/CNS was charged by the leadership of the Congress of Neurological Surgeons to produce a set of evidence based guidelines regarding the performance of lumbar fusion for degenerative disease. The leadership of the Section unanimously voted to approve the production of such guidelines. In order to avoid the perception of industry related bias, the section leadership elected to fund the project entirely through section funds. A guidelines committee was formed consisting of neurosurgeons (Spine Section members) and orthopedic spine surgeons (NASS members) who volunteered to search, sift, read, and interpret the medical literature regarding the performance of lumbar fusion for degenerative disease of the spine.
The methodology used for the formation of the guidelines is identical to that used for the “Guidelines for the Treatment of Cervical Spine and Spinal Cord Injuries” published in March, 2002. A total of fifty treatment and diagnostic recommendations were made. Although “standard” level recommendations were few and far between, there exists literature support for many of the surgical options now offered to patients with recalcitrant low back pain due to degenerative disease. These “Guidelines for the Performance of Fusion for Degenerative Disease of the Lumbar Spine” are scheduled to be published in the Journal of Neurosurgery: Spine, in June of 2005.
We encourage the membership to critically review these guidelines and use them as a benchmark for what the literature currently supports.
Chairman, Guidelines Committee
AANS/CNS Joint Section on Disorders of the Spine