Back Pain Often Ends Without Surgery
Study: Surgery Fastest Treatment for Back and Leg Pain, but Waiting Works, Too
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 it?
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 stenosis.
Patients who underwent surgery had better symptom relief and better daily function starting six weeks after the operation and persisting for at least two years.
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 condition."
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."