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Surgery or No Surgery? That Is the Question
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Posted on: 02/28/2001
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Lumbar spinal stenosis is a term commonly used to describe narrowing of the spinal canal that causes pressure against the spinal cord. The problem is fairly common in people with back pain, especially in older people. There are several different types of conservative (nonsurgical) and surgical treatments for lumbar spinal stenosis. But so far it is unclear whether people get better results with surgery or conservative treatment.
Previously, these authors published the results of a one-year study comparing patients who underwent surgery and those who got conservative treatments for lumbar stenosis. It suggested that patients treated surgically got better faster, had less pain, and were more satisfied with their back condition than patients who got conservative treatments.
But did the results of surgery stand up to the test of time? The authors checked in with the same patients four years later. They found that both groups were doing about the same. However, the group who had surgery was still better off than the nonsurgical group. This held true even when the authors compared patients by their condition when they first saw a doctor for treatment. Significantly, 79% of the patients who had surgery reported that if they could go back in time, they would still have the surgery.
The authors note that poor outcomes are common with lumbar spinal stenosis, no matter how it is treated. Up to 40% of patients who have surgery, and up to 60% who get conservative treatment, are not doing too well after four years. So even though this study sheds some light on its possible benefits, surgery is not necessarily the automatic choice for all patients with lumbar spinal stenosis.
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References:
Steven J. Atlas, MD, MPH, et al. Surgical and Nonsurgical Management of Lumbar Spinal Stenosis: Four-Year Outcomes from the Maine Lumbar Spine Study. In Spine. March 1, 2000. Vol. 25. No. 5. Pp. 556-562.
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