Beaumont researchers: surgery advantageous for spinal stenosis

2/19/2008

Research done at Beaumont Hospital, Royal Oak, along with twelve other sites nationwide, recently published in the New England Journal of Medicine found back surgery for spinal stenosis proved to have better results than nonsurgical treatments. 

The paper is the third in a series detailing the findings of the Spine Patient Outcomes Research Trial or SPORT, a 7-year, $21 million, study funded by the National Institutes of Health.  Beaumont is the only Michigan hospital to have participated in the study.

"The SPORT study is not only unique because of its large size, but because it provides both doctors and patients important information when deciding how to treat back pain," says Harry Herkowitz, M.D., co-author of the article and chief of Orthopedic Surgery, Beaumont, Royal Oak. "Until this study, there had been only a few very small controlled trials to gauge the effectiveness of back surgeries."

Spinal stenosis is narrowing of the spine canal, resulting in pressure on the spinal cord and nerves traveling through the lower back into the legs. The lower back consists of five vertebrae between the ribs and pelvis. Patients with this condition typically experience numbness, leg pain or pain in the buttocks or legs when standing. While it may affect younger patients, it is often a degenerative condition that affects people age 50 and older. Spinal stenosis has many causes including aging, arthritis, inherited conditions, tumors and injuries.

SPORT followed 654 patients diagnosed with spinal stenosis.  Of those, 357 received surgery within two years and 297 were assigned or chose nonsurgical treatments.  Two years after enrollment in the trial, while nonoperative patients reported only moderate improvement in their condition, patients who had surgery reported significantly reduced pain and improved functionality.  Surgical patients saw relief from symptoms fairly quickly, reporting major improvements as early as 6 weeks after their operation.

According to the Feb. 21 New England Journal of Medicine article, "In patients with imaging-confirmed spinal stenosis without spondylolisthesis (slipped vertebra) and leg symptoms persisting for at least 12 weeks, surgery was superior to nonsurgical treatment in relieving symptoms and improving function."

Nonoperative treatments included physical therapy, education/counseling with home exercise and nonsteriodal anti-inflammatory drugs if tolerated by the patient.  Surgery involved relieving pressure on the nerves through removal of bone and soft tissue in a procedure called a decompressive laminectomy.

The Beaumont Hospitals in Royal Oak and Troy provide a full spectrum of specialized care in the diagnosis, treatment and rehabilitation of all orthopedic injuries and conditions. Beaumont's department of Orthopedic Surgery offers leading-edge treatments and technology including minimally invasive surgery, implants and trauma surgery.  Beaumont is Michigan's most experienced orthopedic hospital specializing in surgeries of the back, neck, foot, ankle, hand and upper extremities; hip and knee replacement; scoliosis treatment; tumor surgery; pediatric orthopedics; and sports medicine.  Beaumont has also been named among the country's top hospitals for orthopedic care by U.S. News and World Report for the past five years.