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E-Mail PHILADEPHIA - Since the 1990s the rate of spinal fusion to treat lower back pain has been on the rise. A new prospective clinical study published in the journal Neurosurgery, the official journal of the Congress of Neurological Surgeons, found that lumbar fusions were three times more likely to be effective and obtain better patient outcomes, when guidelines for fusion were followed. The results suggest that when surgeons operate outside of what the evidence based literature suggests, patients may not have significant improvements in their quality of life and could have increased pain or other limitations. Unfortunately, we don t know how many lumbar fusion surgeries are not based on evidence-based best practice, or how these patients do clinically, says neurosurgeon James Harrop, MD, MSHQS professor and chief of the Spine and Peripheral Nerve Surgery division at the Vickie and Jack Farber Institute for Neuroscience - Jefferson Health. The study goal was ....