Spinal Stenosis Surgery Delivers Proven Results

Spinal stenosis is a narrowing of the spinal canal that can lead to compression of the spinal cord or nerve roots. Changes in vertebrae and spinal discs due to arthritis and aging can cause the restriction. When the region of narrowing is the lumbar spine, or lower back, classic symptoms are shooting leg pain or pain and weakness in the buttocks or legs when walking or standing. More adults over 65 undergo a decompressive laminectomy for spinal stenosis than any other spinal surgery.Until now, there has been no conclusive evidence that this surgery is more effective at providing long-term improvement than nonsurgical treatments. “Scientifically valid research on spinal surgery is notoriously difficult to accomplish.” Says Paul T. Rubery, MD of URMC Orthopaedics. Rubery treats spinal stenosis and a host of other spinal conditions operatively and nonoperative. He did not participate in the Spine Patient Outcomes Research Trial (SPORT).

“The SPORT trials are the largest and best-designed efforts to-date to evaluate the modern practice of spinal surgery.“ In the February 21, 2008 New England Journal of Medicine, the authors conclude that patients that had surgery for spinal stenosis had greater improvement in pain, ability to function physically, and physical disability than those that had only nonsurgical therapy. Treatments for spinal stenosis such as physical therapy, anti-inflammatory drugs, epidural steroid injections, and bracing aim to decrease inflammation and relieve pain. Only surgery can correct the compression, though.

The authors found that by three months after surgery, patients had a greater improvement in each measure of medical outcome compared to patients treated only nonsurgically. The sustained advantage of the surgical patients was evident for at least two years.

“This paper in particular shows how effective surgical treatment is for one of the most common maladies of the aging spine, lumbar stenosis. This study should be reassuring to patients who are wondering whether decompressive laminectomy surgery can give them pain relief, and improved quality of life” says Rubery.

Diagnosis of spinal stenosis requires knowledge of patient symptoms, physical examination, and X-rays or Magnetic Resonance Imaging (MRI). Laminectomies carry various risks and are usually performed only after conservative treatments fail. The length of the hospital stay needed depends on the patient and the surgeon. Rehabilitation following surgery can include physical therapy and use of a lower back brace or corset.

Recent reports on the cost and benefits of spinal surgery for back pain have been critical, stating that patient outcomes have not improved, but costs have increased. Dr. Rubery emphasizes the need for treatments with proven benefits.

Spinal Stenosis Surgery Delivers Proven Results

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