Posted by: arisfil | February 21, 2008

Lumbar spinal stenosis update

 NEJMcopyrighted © 2008 Massachusetts Medical Society. All rights reserved.

New England Journal of Medicine hosts the results of the Spine Patient Outcomes Research Trial (SPORT) in its February 21st issue. The investigators designed a 13 U.S multicenter clinical trial about the efficiency of surgical (standard posterior decompressive laminectomy) and non surgical therapy for Lumbar Spinal Stenosis. They screened 1696 patients. Patients with spondylolisthesis and spinal instability were excluded. Finally 289 were enrolled in the randomization cohort and 365 in the observational cohort. They found significant effect of surgery concerning the SF-36 scale for bodily pain and significant advantage for surgery by 3 months for all primary outcomes. The investigators notice that the changes remained significant at 2 years.

Comment:

This is an excellent organized clinical trial that addresses the basic issue of surgical or non-surgical intervention in the field of Lumbar Spinal Stenosis. Although surgery seems to accumulate good outcomes that last, we should note the existence of nonadherence to assigned groups that influence the power of the study. The investigators also address this issue in discussion. 

 

This article is owned by The New England Journal of Medicine which is owned, published, and copyrighted © 2008 by  Massachusetts Medical Society. All rights reserved. 

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Responses

  1. I have been diagnosed with spinal stenosis,I;m 62 years old and have been suffering for the past five years,I have tried lots of antiinflamatory, and they made me very sick, so, I’m living with this pain every day, with advil and suffer every day. I do to the gym three times a week, and tried to be active, but I’m limited because of the pain, this is hell living every day, is there some updates that might help me with my problem, thanking you in advance,

    • The best thing that you should do is to consult a neurosurgeon. The consultation should involve new imaging modalities, especially MRI of the lumbar spine in order to access the degree of tension at the spinal roots. The clinical examination by a neurosurgeon along with the imaging should provide a clear path concerning the indications for a neurosurgical decompression at the region or not. A good neurosurgeon should give you the appropriate info and is going to explain you the indications for surgery. What you need is an examination with an expert in your region. Hope this helped you!


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