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A propensity-matched study of patients with symptomatic lumbar spinal stenosis opting for surgery versus not – Lumbar Spinal Stenosis

The article published in Brain Spine examined the effectiveness of surgical treatment compared to conservative measures for patients with lumbar spinal stenosis (LSS). The study included 149 operated and 149 non-operated patients with LSS, finding that the surgical treated patients showed better improvement in walking ability, health-related quality of life, and leg and back pain compared to non-operated patients. However, the authors suggest further research is needed to more conclusively compare the effectiveness of surgical decompression with non-operative care for LSS patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal centre in London

Published article

INTRODUCTION: Although most surgeons treating patients with lumbar spinal stenosis (LSS) believe that surgical treatment is superior to conservative measures, systematics reviews have concluded that no solid evidence support this.

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Brain Spine. 2024 Apr 5;4:102802. doi: 10.1016/j.bas.2024.102802. eCollection 2024. ABSTRACT INTRODUCTION: Although most surgeons treating patients with lumbar spinal stenosis (LSS) believe that surgical treatment is superior to conservative measures, systematics reviews have concluded that no solid evidence support this. RESEARCH QUESTION: To compare change at 1-year of walking ability, health-related quality of life, leg,

Brain Spine. 2024 Apr 5;4:102802. doi: 10.1016/j.bas.2024.102802. eCollection 2024.

ABSTRACT

INTRODUCTION: Although most surgeons treating patients with lumbar spinal stenosis (LSS) believe that surgical treatment is superior to conservative measures, systematics reviews have concluded that no solid evidence support this.

RESEARCH QUESTION: To compare change at 1-year of walking ability, health-related quality of life, leg and back pain in patients with symptomatic LSS referred to a spine surgery clinic who opted for surgery and those who did not.

MATERIAL AND METHODS: The study included 149 operated and 149 non-operated patients seen by spine surgeons and diagnosed with LSS. The non-operated patients were propensity-matched to a cohort retrieved from the Danish national spine registry. Matching was done on demographics and baseline outcome measures. The outcomes was walking improvement measured by item 4 of the Oswestry Disability Index, EQ-5D-3L, global assessment (GA) of back/leg pain, back and leg pain on the Visual Analogue Scale and the Short Form 36 transition item 2.

RESULTS: Less than half of the non-operated reached MCID on EQ-5D-3L, VAS pain legs or VAS pain back where 2/3 of the operated did. The largest difference was VAS back pain where 27.5% of the non-operated reached an MCID of 12 points compared to 71.8% in the operated group.

DISCUSSION AND CONCLUSION: Surgical treated patients improved better than non-operated on all outcome measures. However, further research is required to compare the effectiveness of surgical decompression with non-operative care for LSS patients.

PMID:38633292 | PMC:PMC11021904 | DOI:10.1016/j.bas.2024.102802

The London Spine Unit : innovative spinal centre in London

Read the original publication:

A propensity-matched study of patients with symptomatic lumbar spinal stenosis opting for surgery versus not

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Brain Spine. 2024 Apr 5;4:102802. doi: 10.1016/j.bas.2024.102802. eCollection 2024. ABSTRACT INTRODUCTION: Although most surgeons treating patients with lumbar spinal stenosis (LSS) believe that surgical treatment is superior to conservative measures, systematics reviews have concluded that no solid evidence support this. RESEARCH QUESTION: To compare change at 1-year of walking ability, health-related quality of life, leg

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