Spine Surgery or Not, Long-Term Outcome the Same

Spinal stenosis surgery can relieve pain, but over time, its results were similar to nonsurgical treatment

(RxWiki News) Thinking about going under the knife for spine problems? It's a tough decision that patients and doctors should discuss. In some cases, the surgery might not make much difference.

A new study found that, eight years after the operation, patients who had surgery for spinal stenosis didn't show differences in pain, function or level of disability from those who didn't have the surgery.

The authors of this study said this work has important implications for doctors who discuss the expected outcome of spinal surgery with their patients.

This new study is the work of a research team at Dartmouth-Hitchcock Medical Center in Lebanon, NH, led by Jon D. Lurie, MD.

Spinal stenosis is a narrowing of the spinal canal. It can be caused by injury, inherited problems, arthritis or bone degeneration from aging. It can cause back and leg pain, as well as other symptoms.

Treatment options include surgery. The surgeon may take out damaged bone or increase the size of the opening for the spinal cord. Like any surgery, spinal surgery carries risks — such as chronic pain, paralysis and infection — and the decision should be made by patient and surgeon only after careful consideration.

Other therapies include exercise, massage, physical therapy and medications. Some patients wear a back brace to support the spine or seek chiropractic treatment or acupuncture. Exercise and physical therapy can strengthen the muscles that support the spine. Medication can relieve or manage pain, reduce inflammation and prevent muscle spasms.

Dr. Lurie and team studied around 650 patients with spinal stenosis. These patients either had surgery or an alternative therapy. Most patients were in their early to mid-60s.

Dr. Lurie and team found that people who had surgery did better for the first four years after the operation. By the fifth year and up to the eighth year, differences between the two groups lessened. By the eighth year, the outcomes between surgery and other treatments were essentially the same.

Of those patients who opted for surgery, however, 18 percent had another surgery for spinal stenosis within eight years of the first surgery.

Dr. Lurie and team noted that, no matter which type of treatment the patient chooses, some pain and a reduced degree of functioning should be expected.

This study was published online Jan. 9 in the journal Spine.

This research was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Office of Research on Women's Health, the National Institutes of Health, the National Institute of Occupational Safety and Health, and the Centers for Disease Control and Prevention.

Some of the study authors received funds for consulting, travel, accommodations, or meeting expenses or owned stock that might constitute a conflict of interest.

Review Date: 
January 12, 2015