Surgery can be more risky as one ages, and researchers at the University of Pittsburgh have found that in the case of lumbar spinal stenosis, surgery may not always be the best option. Lumbar spinal stenosis is common with aging.
“Lumbar spinal stenosis is a narrowing of the spinal canal, usually caused by degenerative changes in the spine,” said Anthony Delitto, principal investigator and chair of the Department of Physical Therapy at Pitt. “There’s a narrowing, and when it becomes symptomatic it results in a person having pain, mostly leg pain, that’s brought on with walking and relieved with sitting. It can be incapacitating pain.”
Many of those suffering from the condition have surgery. This study took a group of people, some had surgery, others had physical therapy and each were tracked for two years.
“At the end point of two years, the results between the two groups were the same in regard to functional improvement and in regard to what we call success,” said Delitto.
This could mean that patients can look into alternative treatment and possibly not need surgery. Delitto says this is a positive, since any type of surgery gets riskier with age.
“We’d like patients as well as their surgeons when they’re going through this shared decision-making process, as to whether or not to have surgery, is to be sure that patient exhaust their non-surgical options before they consent to surgery,” he said.
But, one thing that could stand in the way is cost. Delitto said several people in the study had the surgery because it was less cost-prohibitive than physical therapy, which he said he’d like to see change.
“With the trial we have now and showing that there’s some quality to the physical therapy approach, perhaps policy changes might be in order on the part of some of the payers in regards to copayments and PT,” he said.
Failure rates for those who underwent surgery and those who did physical therapy were also similar in this study.