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.
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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Last Updated: 12/17/08