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."
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,
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