Surgery versus non-surgical treatment for lumber spinal stenosis: A comparative study

Abstract

Background: Surgery for lumbar spinal stenosis remains an option for patients with persistent and severe symptoms that include both back and leg pain. In contrast, in nonsurgical treatment surgeons were encouraged to recommend active physical therapy (PT), education or counseling with home exercise instruction, and nonsteroidal anti-inflammatory medication. The present study was conducted to compare surgery versus non surgical treatment for lumber spinal stenosis. Material and Methods: The present study was conducted to compare surgery versus non surgical treatment for lumber spinal stenosis. Patients were randomly divided into two treatment groups; 1) surgical decompression or 2) physical therapy. The study was then fully explained to the subjects, after which they would be randomly assigned to have surgery or attend physical therapy. The Group I was patients with surgical treatment and Group II was patients with physical therapy. The primary outcome for the study was the Physical Function score on the Medical Outcomes Survey Short Form 36 (SF-36) at baseline, 10 weeks, 26 weeks. All analyses were conducted in SAS version 9.3. Results: In the present study total sample size was 120 subjects per group, with a 50% split by gender (60 subjects per group). The mean age of surgery group was 64.8 and of physical therapy were 68.9. Maximum patients in both groups had no prior back surgeries for the same spinal segment. Baseline Mean changes in physical function for the surgery and PT groups were 25.9 and 28.8 respectively. 10 weeks Mean changes in physical function for the surgery and PT groups were 43.7 and 40.4 respectively. 26 weeks Mean changes in physical function for the surgery and PT groups were 48.1 and 46.5 respectively. Results showed that participants in both groups began to improve at 10 weeks; continued to improve through 26 weeks. Conclusion:The present study concluded that patients began to show improvement at the 10 week mark, continued to improve through 26 weeks of the study.