Back Pain Often Ends Without Surgery
Study: Surgery Fastest Treatment for Back and Leg Pain, but Waiting Works, Too
WebMD News Archive
Spondylolisthesis: Surgery vs. No Surgery continued...
Surgery involves laminectomy, an operation that removes part of the spinal
bone to relieve the pressure on the nerve. The procedure often includes fusing
the affected vertebrae with a bone graft.
Patients tend to be elderly, so surgery carries a risk. Is the risk worth
The answer is a qualified "yes," find James N. Weinstein, DO, of
Dartmouth Medical School in Lebanon, N.H., and colleagues. Weinstein and
colleagues report the two-year outcomes for more than 600 patients with at
least 12 weeks of symptoms from degenerative spondylolisthesis with spinal
Patients who underwent surgery had better symptom relief and better daily
function starting six weeks after the operation and persisting for at least two
But that doesn't mean surgery is for every patient.
"In this study, we see a greater benefit to surgical than nonsurgical
treatment," Weinstein tells WebMD. "But what has never been shown
before is the nonoperation patients do get better. So now there is a basis for
giving patients an informed choice about treatment options for this
Weinstein says that patients with spondylolisthesis should know that back
surgery is very likely to relieve their pain. But they should also know that it
won't bring them all the way back to normal levels of function. And it's also
important for them to know that if they don't want to undergo surgery, they can
still expect significant recovery.
So what should patients do?
"Go to a doctor who will share this information with you, who can
understand your preferences, and help you make the choice that is best for
you," Weinstein says. "This study shows surgery works a little better
than nonsurgical treatment. But there are patients who choose not to have
surgery. And that is a good choice, too."