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Does surgery make a difference for spinal stenosis?

Originally posted by Laura Dyrda with Becker’s Spine Review

The latest publication from the Spine Patient Outcomes Research Trials shows eight-year outcomes data for patients with symptomatic lumbar stenosis. The results were published in Spine.

The study included 13 centers in 11 states where patients were followed for eight years. Here are five findings from the study:

1. The “intent-to-treat” analysis shows no difference between the patients who underwent surgery and those who underwent nonoperative care. But, at eight years, 70 percent of the surgery group and 52 percent of the nonoperative group had undergone surgery.

2. There were early benefits for surgical treatment through four years after surgery, at which point there was no significant treatment effect seen from six to eight years after surgery.

3. The observational group showed stable advantages for surgery in all outcomes from five years to eight years.

4. These patients who were lost to follow up often included:

• Older patients
• Less well-educated
• Sicker
• Worse outcomes during first two years

5. The study authors report, “There was little evidence of harm from either treatment. In the interval between four and eight years, there have not been any cases of paralysis in either the surgical or nonoperative group and there was no statistical difference in morbidity between the surgical and nonoperative groups.”