Washington, Feb 23 : Surgical treatment for a painful, common back condition known as spinal stenosis yields better results than treatment with drugs and physical therapy, says a new study.
Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. It can result in a debilitating pain in the lower back, hips and legs. This is usually due to the natural process of spinal degeneration that occurs with aging.
The study, led by Dr. Howard An, orthopedic spine, back and neck surgeon at Rush University Medical Center, found that patients who underwent surgery for spinal stenosis showed significantly more improvement in all primary outcomes than did patients who were treated nonsurgically.
The surgical solution for the condition involves enlarging the opening to relieve the pressure on the nerves, in an operation called a laminectomy.
The results of the study were based on the Spine Patient Outcomes Research Trial sponsored by the National Institutes of Health that involved about 654 patients at 13 treatment centers across the country.
The study followed 654 surgical candidate patients with a history of at least 12 weeks of symptoms and spinal stenosis, of whom 398 ultimately received decompressive surgery.
After two years, 63 percent of those who had surgery said they had a major improvement in their condition, compared with 29 percent among those who got nonsurgical treatment.
In terms of self-reported pain and function, both groups improved over the two-year period, though the final scores for patient who had surgery were in the 60-point range, while scores for those who stuck with nonsurgical treatments, such as physical therapy, were in the low 40s.
The study separated patients who stuck with their random assignment to surgery or nonsurgery options. The randomized patients' results were very similar to those who selected one course or the other.
The study is published in the journal New England Journal of Medicine.