Surgical or Nonoperative Treatment for Lumbar Spinal Stenosis?

• DOI: 10.1097/01.brs.0000251014.81875.6d
• Publication Date: 2007-01-04T04:43:37Z
• Authors: Antti Malmivaara; Pär Slätis; Markku Heliövaara; Päivi Sainio; Heikki Kinnunen; Jyrki Kankare; Nina Dalin-Hirvonen; Seppo Seitsalo; Arto Herno; Pirkko Kortekangas; Timo Niinimäki; Hannu Rönty; Kaj Tallroth; Veli Turunen; Paul Knekt; Tommi Härkänen; Heikki Hurri
• Keywords: Oswestry Disability Index; Neurogenic claudication; Back Pain

In Brief Study Design. A randomized controlled trial. Objectives. To assess the effectiveness of decompressive surgery as compared with nonoperative measures in treatment patients lumbar spinal stenosis. Summary Background Data. No previous trial has assessed comparison conservative for Methods. Four university hospitals agreed on classification disease, inclusion and exclusion criteria, radiographic routines, surgical principles, options, follow-up protocols. total 94 were into a or group: 50 44 patients, respectively. Surgery comprised undercutting laminectomy stenotic segments 10 augmented transpedicular fusion. The primary outcome was based assessment functional disability using Oswestry Disability Index (scale, 0–100). Data intensity leg back pain (scales, 0–10), well self-reported measured walking ability compiled at randomization examinations 6, 12, 24 months. Results. Both groups showed improvement during follow-up. At 1 year, mean difference favor 11.3 (95% confidence interval [CI], 4.3–18.4), 1.7 CI, 0.4–3.0), 2.3(95% 1.1–3.6) pain. 2-year follow-up, differences slightly less: 7.8 0.8–14.9) 1.5 0.3–2.8), 2.1 1.0–3.3). Walking ability, either reported measured, did not differ between two groups. Conclusions. Although improved over regardless initial treatment, those undergoing greater regarding pain, overall disability. relative benefit diminished time, but outcomes remained favorable 2 years. Longer is needed to determine if these persist. stenosis assessed. group. were: index 0–100), (scale results indicate effect both low