In a report recently published in the journal Spine, long-term outcomes for patients with spinal stenosis are comparable with surgery or conservative treatment. Although earlier reports suggest the advantages of surgery, the updated analysis finds no significant difference in pain, functioning or disability at the eight-year follow-up mark. The researchers analyzed data from the Spine Outcomes Research Trial (SPORT) — one of the largest clinical trials of surgery for spinal disorders. In SPORT, patients meeting strict criteria for spinal stenosis (or other common spinal diagnoses) were randomly assigned to either surgery or nonsurgical treatment (such as physical therapy and medications). Researchers analyzed 654 patients with spinal stenosis, treated at 13 hospitals in 11 states. Of these, 289 were randomly assigned to surgical or nonsurgical treatment. At the eight-year follow-up, surgery was performed in 70 percent of patients randomized to surgery, as well as 52 percent of those initially assigned to nonsurgical treatment. Long-term follow-up data were available for more than 50 percent of patients in both studies. In the “as-treated” analysis of the randomized study, surgery provided better outcomes through four years. However, with longer follow-up, the difference between treatments narrowed. From six to eight years, outcomes were not significantly different between surgical and nonsurgical treatment. The results have important implications for discussing the expected long-term outcomes of treatment for spinal stenosis. To read more about this report, click here.