Surgical vs. Conservative Treatment for Degenerative Lumbar Stenosis

Abstract

Objectives: To compare the clinical outcomes between patients with degenerative lumbar stenosis who were treated by decompression with those awaiting the same kind of treatment for the disease. Methods: Retrospective study which divided patients with degenerative lumbar stenosis with surgical indication in 2 groups, operated and awaiting the procedure. The Oswestry Disability Index (ODI) questionnaire, visual analog scale and SF36 were applied. Results: Twelve operated patients and 18 awaiting the procedure were included. The average age of those operated was 59 years (43-70), and 55 (37-82) (p=0.3) for those awaiting surgery. The operated group had a mean ODI of 38.67 against 59.72 (p<0.05) in the non-operated group. The pain analog scale had lumbar result of 5.33 and pain radiating to the lower limbs of 3.83 in operated patients, against 6.78 (p>0.05) and 7.22 (p<0.05) in the awaiting surgery patients, respectively. As for the SF36 scale, functional capacity, limitations due to physical aspects and pain had an average score of 36.25, 19.58 and 21.67 in the operated group against 35.94, 27.50 and 32.61 in the awaiting group (p>0.05), respectively. Conclusion: The operated patients showed improvement of referred pain in the lower limbs (leg VAS) and improved function (Oswestry), however showed no significant change in quality of life according to SF36 scale and low back pain (lumbar VAS) were found. 55 (37-82) (p = 0,3). el grupo operado tuvo odi promedio de 38.67 contra 59.72 del grupo de espera (p < 0,05). la escala analógica del dolor lumbar tuvo resultado de 5,33 y el dolor que se irradia a las extremidades inferiores de 3,83 en los operados contra 6,78 (p > 0,05) y 7,22 (p < 0,05), respectivamente, en el grupo de espera de la cirugía. en cuanto a la escala sF-36, la capacidad funcional, las limitaciones debidas a aspectos físico y el dolor tuvieron puntuación media de 36,25, 19,58 y 21,67 en pacientes operados contra 35,94, 27,50 y 32,61, respectivamente, en los que esperan la cirugía (p > 0,05). conclusión: los pacientes operados mostraron una mejoría del dolor referido en las extremidades inferiores (eva de la pierna) y mejoría de la función (oswestry). sin embargo, no se observaron cambios significativos con respecto al dolor lumbar (eva lumbar) ni en la calidad de vida medida a través del cuestionario sF-36.

Respiratory function in patients with lumbar stenosis

“…[1][2][3][4] The degenerative process is frequently divided into three distinct stages, namely dysfunction, instability, and stabilization. [3][4][5] It can be considered normal due to aging and may not necessarily be the cause of painful conditions, 2 but can also result in pain syndromes affecting the spine, the upper or lower limbs, and may also be associated with neurological disorders of the lower and the upper limbs caused by compression on the spinal cord and nerve roots, such as: disc herniation, spinal stenosis, a narrowing of the spinal canal, and also infections, tumors, arthritis, and arthrosis. 1,2 There is a number of approaches to treating pain syndromes.…”