Comparison between surgical procedures and conservative treatments to reduce disability caused by low back pain - systematic review and meta-analysis / Comparação entre procedimentos cirúrgicos e tratamentos conservadores para redução de incapacidade causada pela dor lombar - revisão sistemática e metanálise

Abstract

Introduction- Low back pain affects all age groups and through surgical procedures or conservative treatments, the effects caused are reduced, usually assessed by the Oswestry questionnaire. Objective-. The purpose of this meta-analysis was to compare the decrease in disability after surgical and conservative intervention, using the Oswestry Disability Index. Methods- This is a systematic review and meta-analysis, searching the databases: PubMed, SciELO and LILACS. Articles that provided data on the Oswestry deficiency index were considered, with a randomized methodology after surgical and conservative intervention in low back pain at 12 and 24 months of intervention. After tabulation of the data according to the PRISMA protocol, the test was performed to determine the difference between the means. Statistical analyzes were performed using the STATA® 16.0 software. Results- There was an average reduction of 15 points in the Oswestry questionnaire, after conservative treatment in 12 months and after 24 months, the average reduction was approximately 12 points. Surgical intervention, when compared to therapy, was superior with an average difference of approximately 15 points after 12 months and an average difference of 15 points after 24 months. Conclusion- The approach chosen despite the results needs to be assessed according to the condition of each patient. Surgical treatment, even with better results, presents risks of surgical complications that cannot be omitted. In conservative treatment, it is necessary to check the patient's response to treatment, so as not to prolong the individual's time of disability and pain.