Spine-Health has blogged in the past about the Spine Patient Outcomes Research Trial (SPORT), including one study concluding that back surgery was better for patients with degenerative spondylolisthesis.
More specifically, previous findings indicated that patients who chose to treat their lumbar degenerative spondylolisthesis via decompressive laminectomy surgery (either with or without fusion) experienced more back pain relief two years later than those patients who elected non-surgical treatments such as NSAIDs, physical therapy and steroid injections.
Well, SPORT just recently released the latest data on this study. Its verdict? The newest data supported this earlier conclusion, finding that back pain relief was more prevalent four years later for those patients who voluntarily had lumbar laminectomy surgery as opposed to those who voluntarily passed on this surgery.
Here’s a quick summary of these latest SPORT findings:
Identical Approach, Longer-Elapsed Time Frame, More Crossover, Similar Results.
To recap, there were two cohorts in this study: 304 patients in a randomized cohort (meaning that they were randomly chosen either to have or not have laminectomy surgery to treat their spondylolisthesis and spinal stenosis) and 303 patients in an observational cohort (meaning that these patients voluntarily chose to have or not have this surgery).
It should be known that 66 percent of those patients who were randomly chosen to have surgery did so within four years and that 97 percent of those patients who chose surgery also had a laminectomy in that time period.
More telling were the latest findings that 54 percent of those people who were randomized not to have surgery ended up having surgery within four years and that 33 percent of those who voluntarily passed on surgery eventually had it. For more than a half and approximately a third of these specific patients, not having surgery apparently wasn’t as beneficial in terms of providing back pain relief.
Adding more intrigue to this study were the responses of those patients who voluntarily had surgery for their back pain. This group of patients reported improvements of 15.3 points for bodily pain and 18.9 points for physical function, and decreases of 14.3 points on the Oswestry Disability Index, signifying that gains experienced two years after back surgery were still maintained four years later.
At the end of the day, these latest findings confirm how laminectomy surgery may have wonderful results for people dealing with spondylolisthesis. Still, one must not rush to assume that surgery is always better than not having surgery when addressing spondylolisthesis associated with spinal stenosis. It should be noted that non-surgical treatments may adequately alleviate back pain for others, as very well may have been the case for the 70 percent of the observational patients who initially passed on and still did not have surgery four years later.
As each patient’s case is unique in itself, it ultimately comes down to the patient and his or her doctor examining their options and making a decision that they are most comfortable with and feel is the best course of action at the time.