Ask to take part

Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Ms Odette Dawkins
+44 (0)7500 072555
odette.dawkins@ndorms.ox.ac.uk


Dr Study team contact -
-
forensic@ndorms.ox.ac.uk


Prof Sashin Ahuja
-
sashin.ahuja@wales.nhs.uk


Prof David Beard
+44 (0)1865 737 929
david.beard@ndorms.ox.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - FORENSIC-UK: Fusion versus Best Conservative Care

FORENSIC-UK: Fusion versus Best Conservative Care

Medical Conditions

Low back pain


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


Low back pain is common for many people and often improves without specific treatment. However, for some people their low back pain does not go away, and the use of painkillers and physiotherapy (which we call non-surgical treatment) is often successful as the first line of treatment. There has also been good research to show that this treatment is beneficial. However, this approach does not work for everyone, and some people are left with ongoing severe low back pain impacting their health, daily activities and work. Some medical professionals think that an operation called spinal fusion may help. The study aims to investigate whether treating low back pain with surgery is better than using non-surgical treatment for patients with long-standing back pain that has not responded to previous non-surgery treatment, and also whether the spinal fusion surgery is good value for money for the NHS.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

30 Jun 2025 30 Sep 2026

Participants will be randomly allocated to either Spinal Fusion Surgery or personalised Best Conservative Care.
Spinal Fusion Surgery: this group will receive Spinal Fusion Surgery, an operation to surgically fix the spinal bones together in their lower back.
Best Conservative Care: this group will undergo a personalised non-surgical treatment plan which will be specially created for the patient using a shared decision-making tool between the treating clinician and the participant. It can include checking and maybe adjusting the participants' current medication, exercise, self-management, pain control, and signposting to other NHS services. Participants will be asked to complete questionnaires relating to their treatment, pain and quality of life at 6,12 and 24 months. Participants will be able to complete questionnaires electronically or on paper according to their preference.


Participants can join the study if they:
1. Have severe and ongoing low back pain for 6 months or more
2. Have had some non-surgical care to help with back pain in the past 6 months or more, which has been unsuccessful
3. Are aged between 18 and 65 years
4. Suitable to receive either spinal fusion surgery or the best conservative care

You can take part if:



You may not be able to take part if:


1. Has low-back related leg pain more severe than low back pain, e.g. claudication2. Pain in any other body region more severe than low back pain3. Previous (or attempted) LFS4. Has psychiatric disorders (e.g. diagnosed personality disorders, post-traumatic stress disorder, drug or alcohol abuse/addiction, diagnosis of severe depression).5. Radiculopathy or claudication or clinical signs of nerve decompression where the treatment plan includes offering a direct or indirect decompression along with the fusion6. Any other reasons indicated for lumbar fusion surgery (LFS), e.g. deformity, infection, tumours, instability (due to spondylolisthesis of grade 2 or above), spinal fracture, systematic inflammatory disease


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • Sheffield Teaching Hospitals NHS Foundation Trust
    Northern General Hospital Herries Road
    Sheffield
    S5 7AU
  • University Hospitals Coventry and Warwickshire NHS Trust
    Walsgrave General Hospital Clifford Bridge Road
    Coventry
    CV2 2DX
  • Nottingham University Hospitals NHS Trust
    Trust Headquarters Queens Medical Centre Derby Road
    Nottingham
    NG7 2UH
  • University Hospitals of North Midlands NHS Trust
    Newcastle Road
    Stoke-on-trent
    ST4 6QG
  • Belfast Health and Social Care Trust
    Trust Headquarters A Floor - Belfast City Hospital Lisburn Road
    Belfast
    BT9 7AB
  • Leeds Teaching Hospitals NHS Trust
    St. James's University Hospital Beckett Street
    Leeds
    LS9 7TF
  • The Royal Wolverhampton NHS Trust
    New Cross Hospital Wolverhampton Road Heath Town
    Wolverhampton
    WV10 0QP
  • Milton Keynes University Hospital NHS Foundation Trust
    Standing Way Eaglestone
    Milton Keynes
    MK6 5LD
  • University Hospitals of Derby and Burton NHS Foundation Trust
    Royal Derby Hospital Uttoxeter Road
    Derby
    DE22 3NE
  • Whittington Health NHS Trust
    The Whittington Hospital Magdala Avenue
    London
    N19 5NF
  • The Walton Centre NHS Foundation Trust
    Lower Lane Fazakerley
    Liverpool
    L9 7LJ
  • Lancashire Teaching Hospitals NHS Foundation Trust
    Royal Preston Hospital Sharoe Green Lane Fulwood
    Preston
    PR2 9HT
  • Somerset NHS Foundation Trust
    Trust Management Lydeard House Musgrove Park Hospital
    Taunton
    TA1 5DA
  • The Royal Orthopaedic Hospital NHS Foundation Trust
    The Woodlands Bristol Road South Northfield
    Birmingham
    B31 2AP
  • Stockport NHS Foundation Trust
    Stepping Hill Hospital Poplar Grove
    Stockport
    SK2 7JE
  • Berkshire Healthcare NHS Foundation Trust
    London House London Road
    Bracknell
    RG12 2UT
  • University College London Hospitals NHS Foundation Trust
    The National Hospital for Neurology and Neurosurgery Queens Square
    London
    WC1N 3BG
  • Northumbria Healthcare NHS Foundation Trust
    Northumbria Way Cramlington
    Northumberland
    NE23 6NZ
  • Cardiff and Vale University Health Board
    Cardiff and Vale Orthopaedic Centre
    Cardiff
    CF14 4XW
  • Swansea Bay University Health Board
    Morriston Hospital
    Swansea
    SA6 6NL
  • Solent NHS Trust
    St Mary's Community Health Campus
    Southampton
    SO16 6YD

The benefits of taking part are that participants' back pain may improve, and that physiotherapy or pain relief may no longer be required following either spinal fusion surgery or best conservative care.
For all participants, the risks are that the pain may not improve and the side effects of medication. Also, there is exposure to a low-level magnetic field if you have an MRI scan, or low-level radiation due to the CT/SPECT scan, to check if you are suitable for this study. For those receiving surgery, there are the risks associated with any operation (e.g. bleeding from the wound site) and general anaesthetic (e.g. nausea, headache), and exposure to low-level radiation due to the CT scan at 2 years post-surgery. For those receiving best conservative care, there is a risk of increased pain associated with exercise. All procedures used in this study are known in the NHS and deemed safe.

Prof David Beard
+44 (0)1865 737 929
david.beard@ndorms.ox.ac.uk


Prof Sashin Ahuja
-
sashin.ahuja@wales.nhs.uk


Dr Study team contact -
-
forensic@ndorms.ox.ac.uk


Ms Odette Dawkins
+44 (0)7500 072555
odette.dawkins@ndorms.ox.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by University of Oxford and funded by National Institute for Health and Care Research.




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Read full details for Trial ID: ISRCTN74906087

Or CPMS 66893

Last updated 01 July 2025

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