External spinal skeletal fixation in the management of back pain.

External spinal skeletal fixation, pioneered by the Association for the Study of Internal Fixation as an alternative in thoracolumbar fracture management, has been effective in temporarily relieving mechanical low back pain. This investigational technique was been proposed as an alternative in the selection of patients with back pain as candidates for pain relief through fusion. This is the report of a prospective and randomized clinical trial that has defined prognostic benefit (good outcome in 61% of control patients versus 90% of the study group) in selecting patients with mechanical back pain (verified through facet blocks or discograms) as candidates for pain relief through fusion surgery.