Abstract
Purposes of the study and background: We set out to demonstrate whether there is a significant difference in the outcome of patients treated surgically and non-surgically for lumbar spine stenosis at two-year follow-up. In the literature, few prospective controlled trials exist which compare non-surgical to surgical treatment in spinal stenosis. Therefore, evidence for the best management of this condition is limited.
Methods: From prospectively collected data between January 1993–January 1999 two groups were identified. To minimize differences in baseline characteristics patients were matched for age, sex and Oswestry score at the outset. The outcome measures recorded were an Oswestry Disability index/Spine Function Questionnaire (including Visual Analogue Score)/Modified Somatic Perception and Modified Zung Depression Index (at initial visit and two year follow-up).
Results: Twenty matched pairs were identified: twelve male and eight female. One hundred percent follow-up was achieved in each group. The mean follow-up was two years. In the surgical group, twelve were instrumented and eight uninstrumented. The extent of the decompression and fusion was as follows: three were a single-level fusion, ten two-level, four three-level and three four-level. In the non-surgical group, two received no treatment, thirteen a single form of treatment (Physiotherapy/Root canal injection/Salmon Calcitonin) and five received two or more of the above treatments. The differences in the outcomes between the groups at baseline and two years were not statistically significant except for pain (p< 0.05). However, all measures improved in both groups over the two years.
Conclusion: Surgical decompression for lumbar spinal stenosis significantly decreases pain at two year follow-up compared to those treated non surgically.
The abstracts were prepared by Dr P Dolan. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
