Navigation Links
Surgery Best for Narrowing of Spine
Date:2/20/2008

Study says it beat nonsurgical care for painful condition that often accompanies aging

WEDNESDAY, Feb. 20 (HealthDay News) -- The largest study of its kind concludes that surgery is better than nonsurgical treatments for spinal stenosis, a painful narrowing of the spine that stems from the normal deterioration that accompanies aging.

People who underwent an operation showed more improvement in pain, function, satisfaction and self-rated progress than those who received the typical, nonsurgical care.

But the procedure should not be overused, warned the authors of the study, which is published in the Feb. 21 issue of the New England Journal of Medicine.

"We don't want people to surmise that because this works, all spine surgery is good," said study author Dr. James Weinstein, chairman of the department of orthopedics at Dartmouth Medical School, in Lebanon, N.H. "These people all had very specific physical findings and diagnostic criteria. In these specific cases, this is a good operation. This is not a back pain operation."

Although surgery to correct the condition is common, particularly among those over the age of 65, Weinstein noted there was little objective evidence on the effectiveness of such a procedure.

"Studies have not been done in a way that might be generalizable or usable for the rest of country," Weinstein said.

The study involved two groups of patients: 289 who were randomized to receive surgery or usual nonsurgical care (physical therapy, education or counseling with home exercise instruction, and non-steroidal anti-inflammatory drugs if indicated), and 365 who did not want to be randomized and so were assigned to an "observational" group. In all, 13 clinics in 11 states were involved.

All participants had had at least 12 weeks of symptoms of spinal stenosis, without spondyloisthesis (when a vertebra in the lower part of the spine slips), as confirmed by imaging.

After two years, two-thirds of patients who had been randomly assigned to surgery had actually undergone surgery, while 43 percent of those in the nonsurgical group had also undergone surgery.

Surgery was twice as effective as nonsurgical treatment in addressing symptoms and improving actual function. Some improvements were seen as early as six weeks post-surgery, reaching their peak at six months and continuing for two years.

"I was hoping as a spine surgeon that it really worked, and we found that it did," Weinstein said. "It looks like from our results that surgery is better than non-surgery."

"People who received nonsurgical care did a little better, but not a lot. They pretty much stayed the same," Weinstein said. "Operative patients get a lot better, comparatively."

But there's an argument for both approaches. "One thing I learned is there's still a choice," Weinstein said. "Nobody got worse with or without surgery."

Another expert applauded the research.

"This study confirms what surgeons have felt all along," said Dr. Mark D. Rahm, assistant professor of surgery at Texas A&M Health Science Center College of Medicine. "It points out that people who are symptomatic enough to want to do surgery can feel good about the fact that it will likely improve their overall condition."

More information

The American Academy of Orthopaedic Surgeons has more on spinal stenosis.



SOURCES: James Weinstein, D.O., chairman, department of orthopedics, Dartmouth Medical School, and director, Dartmouth Institute of Health Policy and Clinical Practice, Lebanon, N.H.; Mark D. Rahm, M.D., assistant professor of surgery, Texas A&M Health Science Center College of Medicine, and director, Division of Spine Surgery, Scott & White, Temple, Texas; Feb. 21, 2008, New England Journal of Medicine


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. More Evidence of Danger From Heart Surgery Drug
2. Surgeons Rethink Approach to Minimal Incision Foot and Ankle Surgery
3. Achilles Tendon Surgery Advances Speed Recovery
4. Hospital for Special Surgery shares best practices to benefit of British patients
5. Study Shows New Therapy Opens Blocked Fallopian Tubes, Returns Fertility Without Surgery
6. Chemotherapy After Breast Cancer Surgery Effective for Older Women, Too
7. $4 million award to improve detection of acute kidney injury after cardiac surgery
8. Surgery improves quality of life for children with sleep apnea
9. Northwestern Memorials Heart Center Pioneers Minimally Invasive Surgery That Corrects Irregular Heart Beat
10. NOVADAQs SPY System to be Featured During Live Broadcast of Robotic Surgery
11. Benefit of cancer prevention surgery differs between women with BRCA1 and BRCA2 mutations
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Surgery Best for Narrowing of Spine
(Date:10/12/2017)... ... 12, 2017 , ... IsoComforter, Inc. ( https://isocomforter.com ), one of ... innovative new design of the shoulder pad. The shoulder pad provides optimal support ... your pain while using cold therapy. By utilizing ice and water that is circulated ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... that we intend to develop to enable prevention of a major side effect ... hearing loss, especially in pediatric patients. For cisplatin, hearing loss is FDA listed ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at Children’s National ... 49th Congress of the International Society of Paediatric Oncology (SIOP) Oct. 12-15. ... for Cancer and Blood Disorders at Children’s National, and Stephen P. Hunger, M.D., ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health ... interactive health literacy software tool, and the Cancer Patient Education Network (CPEN), an ... education, today announce a new strategic alliance. , As CPEN’s strategic partner, ...
(Date:10/12/2017)... ... October 12, 2017 , ... Farm Forward ... Berkeley, and other leading institutions in announcing the launch of the Leadership ... the way animals are raised for food. , Founding members of the Leadership ...
Breaking Medicine News(10 mins):
(Date:9/28/2017)... , Sept. 28, 2017 Cohen Veterans ... advance the use of wearable and home sensors for ... disorders. Early Signal Foundation, a nonprofit organization focused on ... will provide an affordable analytical system to record and ... ...
(Date:9/23/2017)... 22, 2017 Janssen Biotech, Inc. (Janssen) announced ... from the U.S. Food and Drug Administration (FDA) for ... for the treatment of moderately to severely active rheumatoid ... data are needed to further evaluate the safety of ... RA. "We ...
(Date:9/18/2017)... , Pa. and KALAMAZOO, Mich. , Sept. ... Penn. , and OptiMed Specialty Pharmacy of ... partnership to offer a strategic hub service that expedites ... highly sought-after personal spirometer, Spiro PD 2.0, and wellness ... A spirometer is a medical device used to measure ...
Breaking Medicine Technology: