Treatment for Lumbar Spinal Stenosis Still DebatedIf you're an older adult with lumbar spinal stenosis (LSS) (narrowing of the spinal canal), surgery may be an option. But if you can get pain and symptom relief without surgery, there's less chance of other problems and complications. In this study researchers look at the result of conservative care for LSS. They try to find any factors that will predict outcome to help seniors make this treatment decision.
The study started out with 263 patients 70 years or older. Everyone was treated in the hospital. First they tried in-bed pelvic traction. If that didn't work the patients got a body cast to put the spine in slight flexion, a position known to help with LSS. Corsets, injections, and nerve root blocks were also used if nothing worked so far.
In the end 140 patients had surgery because none of the conservative treatments worked. This study focused on the final 89 patients who got better and left the hospital without having surgery.
They found that patients most likely to do well with conservative care had the radicular type of LSS. This means there was pressure on the spinal nerve roots as they exited the spinal canal. The patients with the worst results had complete nerve block as shown with myelogram (dye injected into the spinal canal).
Kou Takokoro, MD, et al. The Prognosis of Conservative Treatments for Lumbar Spinal Stenosis. In Spine. November 1, 2005. Vol. 30. No. 21. Pp. 2458-2463.
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