In this study, provocative discography screening did not improve surgical outcomes after circumferential fusion for lumbar discogenic back pain.

The authors consider instrumented circumferential fusion with posterior lumbar interbody fusion better than instrumented posterolateral fusion for managing chronic disabling low back pain.

Ninety patients having had posterolateral or circumferential fusion (indicated by chronic low back pain and localized pathology) were randomized 3 months after their spinal fusion.

Circumferential fusion was compared to PLF, but no difference could be found.

Thirty-six instrumented posterolateral fusions and 35 instrumented circumferential fusions with posterior lumbar interbody fusions were done simultaneously.