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Individuals suffering from a common back condition known as spinal stenosis
improve more with surgery than with non-surgical treatment, according to a
multicenter, multistate trial led by Dartmouth clinician-researchers. The
research, published in the Feb. 21 New England Journal of
Medicine, is the third in a series of study results from the Spine Patient Outcomes Research
Trial (SPORT.) The seven-year, $21 million trial is led by James N.
Weinstein, professor and chair of the departments of Orthopaedics at Dartmouth Medical School and Dartmouth-Hitchcock Medical Center, and
director of the Dartmouth Institute
for Health Policy and Clinical Practice. Weinstein, a practicing spine
surgeon, says the study will be significant for millions of patients and their
doctors.
James Weinstein (Photo by Mark Washburn)
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The SPORT studies were launched in 2000 to look at the three most common
back conditions leading to surgery. The spinal stenosis studies show a marked
advantage for those patients who had surgery. Surgical patients improved more
rapidly and reported better physical function and less pain than did the
non-surgical patients, who reported only moderate improvement two years after
their diagnosis. However, the study also reveals that patients who choose not
to have surgery are likely to improve over time.
Weinstein say it’s significant that almost none of the non-surgical patients
got worse without an operation. On average, they reported small improvements in
all measures. “What we now know and can share with our patients is that they
have a choice. If they choose surgery, they will improve greatly. But if their
preference is not to have surgery, their condition is not likely to worsen and
they will see some improvement over time,” he says.
Studies from the SPORT trial looking at cost-effectiveness and other
measures will be released in coming months. SPORT was funded in large part by
the National Institutes of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS) at the National Institutes of Health (NIH).
By DEBORAH KIMBELL
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