Common spinal problem eased with surgery

Feb 21 2008

Researchers in the United States have found that people who underwent surgery for spinal stenosis had less pain two years later than those who decided not to undergo surgery.

Spinal stenosis is the most a common back problem particularly in people over 65 and is the result of a narrowing of the spinal canal that gradually pinches off nerves in the spine, making it painful to stand or walk.

The operation involves surgeons removing some of the bone and tissue from inside the spinal cord that pinches the nerves which then sends severe pain down the buttocks and legs of patients.

The researchers say the study should help patients make a more informed decision when they develop the painful condition.

The research was part of a five-year, 11-state study known as the Spine Patient Outcomes Research Trial, looking at the effectiveness of common back surgery.

Dr. James Weinstein of Dartmouth College in New Hampshire says they found that the spinal stenosis part of the study showed that while surgery patients fared better even after two years, patients who did not have the surgery were able to live with their pain.

He says non-surgical therapies or watchful waiting are options.

Earlier research, which was also part of the Spine Patient Outcomes Research Trial, found patients with painful herniated disks in the lower back recover with or without surgery, although surgery helped relieve pain faster.

Another large study published last week also found Americans with back pain are not getting much relief despite annual spending of $86 billion on popular spine treatments.

Weinstein and his team looked at 289 patients who were randomly selected to have either surgery or non-surgical care, which included physical therapy and pain medication and some made their own choice about treatment.

The team found after two years, 67 percent of patients assigned to have surgery did have it done along with 43 percent of the patients assigned to skip surgery.

Weinstein says the patients who had surgery had more pain relief, less disability and better function than those getting usual care.

Those who crossed over to the surgery group had apparently reported more severe pain and were in more distress while the patients who delayed the surgery in general has less severe symptoms.

Weinstein says nevertheless the study found both groups clearly benefited from surgery.

The study which is published in the New England Journal of Medicine, was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.