Question: In patients with severe chronic low-back pain requiring posterolateral spinal arthrodesis, is the long-term outcome after supplemental pedicle-screw fixation (instrumented) better than that after spinal arthrodesis without pedicle-screw instrumentation (noninstrumented)?
Design: Randomized (allocation concealed)*, blinded (data collectors and outcome assessors)*, controlled trial with a 5-year follow-up.
Setting: A university hospital in Aarhus, Denmark.
Patients: 130 patients (mean age, 45 years [range, 20 to 70 years]; 53% women) who had severe chronic low-back pain because of localized lumbar or lumbosacral segmental instability due to Grade-I or Grade-II isthmic spondylolisthesis, primary degenerative instability, secondary degenerative instability after …
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