(February 20, 2008 - Insidermedicine) Surgery is a more effective option for spinal stenosis than usual nonsurgical care, according to a trial published in the New England Journal of Medicine.

Here is some information regarding the benefits of surgery vs. medical therapy for spinal stenosis from the North American Spine Society:

•    At long-term follow-up (8-10 years), surgical decompression in the treatment of lumbar spinal stenosis is consistently supported when compared to medical/interventional treatments.

•    Patients aged 75 or older with lumbar spinal stenosis show the same benefit from lumbar decompression as younger patients aged 65-74.

•    Diabetic patients 65 and older with lumbar spinal stenosis benefit from lumbar decompression.

Researchers from Dartmouth Medical School conducted a trial in which patients who had spinal stenosis without spondylolisthesis confirmed via imaging as well as painful symptoms of the condition lasting at least 12 weeks received either decompressive surgery or usual nonsurgical care at one of 13 spine clinics in the U.S. Overall, 289 patients agreed to be randomized to one therapy or the other; an additional 365 patients who did not agree to randomization were also included in the analysis as part of an observational cohort.

Despite poor adherence to the treatments selected via randomization, an intent-to-treat analysis of the randomized cohort still revealed greater improvement with surgery than usual care with respect to bodily pain. An as-treated analysis combining both the randomized and observational cohorts and adjusting for potential confounders revealed a significant improvement with surgery starting at three months and lasting out to two years for all three primary outcomes—bodily pain, physical functioning, and disability level.

Today’s research demonstrates that surgery is a good option for spinal stenosis, since it provides pain relief and improvement in physical functioning that may not be obtainable with nonsurgical measures.

For Insidermedicine in Depth, i'm Dr. Susan Sharma.