Surgery an Option for Spinal Stenosis
But Spinal Fusion Isn’t Needed, Researcher Says
WebMD News Archive
Surgery Not the Only Option
In part of the study, 289 patients were randomly assigned to have
surgery or nonsurgical treatments, including physical therapy and pain
But after two years, only 67% of the patients assigned to surgery had had
the decompression procedure, and 43% of patients assigned to nonsurgical care
had opted for surgery.
Another part of the study included 365 patients for whom no specific
treatment was assigned. These patients were followed on their choices of
surgical or nonsurgical treatment.
Though the surgically treated patients fared better in terms of pain and
function in the combined analysis of both study parts, the researchers reported
little evidence of harm from either treatment.
Surgery-related complications were uncommon, and patients treated without
surgery showed some improvement over the two-year follow-up.
"Often patients fear they will get worse without surgery, but this was
not the case for the majority of patients in the non-surgical group, who, on
average, showed small improvements in all outcomes," the researchers
The message is clear, Weinstein says: Patients need to understand that
surgery is not the only treatment option for spinal stenosis.
"Surgery is an elective procedure for this condition," he says.
"Some patients find that they can live with their symptoms, and others find
they can't. It is up to the physician to provide the information the patient
needs to make an informed choice."
Clinician and back pain researcher Richard Deyo, MD, agrees.
Deyo is the Kaiser Permanente professor of evidence-based family medicine at
the Oregon Health and Science University in Portland.
"The key is for patients to understand their choices and to understand
what to expect from those choices," he says. "If they are well informed
and clearly have a preference, this study finds that either surgical or
nonsurgical treatment is a reasonable choice."