Featured Research

from universities, journals, and other organizations

For most patients, surgery is best treatment for spinal stenosis, study finds

Date:
October 9, 2012
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
Nearly all groups of patients with spinal stenosis -- but not smokers -- do better with surgery than with nonsurgical treatment, reports a new study.

Nearly all groups of patients with spinal stenosis -- but not smokers -- do better with surgery than with nonsurgical treatment, reports a study in the October 1 issue of Spine.

Related Articles


The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"With the exception of smokers, patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment," according to the study by Dr Adam Pearson and colleagues of The Dartmouth Institute for Health Policy and Clinical Practice. They suggest that patients who smoke should consider quitting before they undergo surgery for spinal stenosis.

For Nonsmokers, Better Results for Surgery for Spinal Stenosis

The researchers analyzed data from the Spine Outcomes Research Trial (SPORT) -- one of the largest clinical trials of surgery for spinal disorders. In SPORT, patients meeting strict criteria for spinal stenosis (or other common spinal diagnoses) were randomly assigned to surgery or nonsurgical treatment (such as physical therapy and medications). Patients with spinal stenosis have narrowing of the spinal canal, causing back pain, leg pain, and other symptoms.

In the study, 419 patients with spinal stenosis underwent surgery while 235 received nonsurgical treatment care. The difference in scores on a 100-point disability rating scale was calculated to assess the "treatment effect" of surgery compared to nonsurgical treatment. A wide range of characteristics were analyzed for their ability to predict which groups of patients would do better with surgical or nonsurgical treatment.

The results consistently showed greater improvement after surgery. "Other than smokers, all analyzed subgroups including at least 50 patients improved significantly more with surgery than with operative treatment," Drs Pearson and coauthors write. With adjustment for other factors, smokers who had surgery gained only two points on the disability scale, compared to those who had nonsurgical treatment.

Some characteristics besides smoking predicted greater improvement with surgery, such as a lower initial disability score, the presence of neurological abnormalities, and certain types of spinal stenosis, and no lifting on the job. For patients with the six strongest favorable characteristics, the predicted treatment effect of surgery was a 24-point improvement in disability score, compared to nonsurgical treatment.

Findings Will Help to Guide Treatment Decision-Making

The SPORT study was designed to increase the scientific evidence for decisions about treatment for spinal disorders. The finding that most patients with spinal stenosis do better with surgery -- including those with initially lower disability -- contrasts with the "conventional wisdom" that surgery is most appropriate for patients with the worst initial symptoms. Dr Pearson and coauthors emphasize that their results apply only to patients meeting the strict SPORT criteria for spinal stenosis: persistent, typical symptoms with imaging studies to confirm narrowing of the spinal canal.

The "most striking finding" is the importance of smoking -- with smokers getting about the same improvement with or without surgery. It's not clear whether smoking is the cause of the decreased response to surgery or "simply a marker for other characteristics responsible for the association," the researchers write. Until that question is answered, they believe that "Smoking cessation should be considered prior to surgery for spinal stenosis."

The findings also highlight the importance of considering individual characteristics when making treatment decisions -- with patients participating in the decision as much as possible. Dr Pearson and coauthors conclude, "These data can be used to help individualize shared decision making discussions about likely outcomes following surgical or nonoperative treatment for spinal stenosis."


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Adam Pearson, Jon Lurie, Tor Tosteson, Wenyan Zhao, William Abdu, James N. Weinstein. Who Should Have Surgery for Spinal Stenosis? Treatment Effect Predictors in SPORT. Spine, 2012; 37 (21): 1791 DOI: 10.1097/BRS.0b013e3182634b04

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "For most patients, surgery is best treatment for spinal stenosis, study finds." ScienceDaily. ScienceDaily, 9 October 2012. <www.sciencedaily.com/releases/2012/10/121009141726.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2012, October 9). For most patients, surgery is best treatment for spinal stenosis, study finds. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2012/10/121009141726.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "For most patients, surgery is best treatment for spinal stenosis, study finds." ScienceDaily. www.sciencedaily.com/releases/2012/10/121009141726.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Reuters - Innovations Video Online (Oct. 29, 2014) A Swedish amputee who became the first person to ever receive a brain controlled prosthetic arm is able to manipulate and handle delicate objects with an unprecedented level of dexterity. The device is connected directly to his bone, nerves and muscles, giving him the ability to control it with his thoughts. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Google To Use Nanoparticles, Wearables To Detect Disease

Google To Use Nanoparticles, Wearables To Detect Disease

Newsy (Oct. 29, 2014) Google X wants to improve modern medicine with nanoparticles and a wearable device. It's all an attempt to tackle disease detection and prevention. Video provided by Newsy
Powered by NewsLook.com
Can Drinking Milk Lead To Early Death?

Can Drinking Milk Lead To Early Death?

Newsy (Oct. 29, 2014) Researchers in Sweden released a study showing heavy milk drinkers face an increased mortality risk from a variety of causes. Video provided by Newsy
Powered by NewsLook.com
Obama: The US Will Not 'run and Hide' From Ebola

Obama: The US Will Not 'run and Hide' From Ebola

AP (Oct. 29, 2014) Surrounded by health care workers in the White House East Room, President Barack Obama said the U.S. will likely see additional Ebola cases in the weeks ahead. But he said the nation can't seal itself off in the fight against the disease. (Oct. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins