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A prospective study of non-surgical versus surgical treatment for lumbar spinal stenosis without instability

 Jong-Myung Jung  ;  Seung-Jae Hyun  ;  Ki-Jeong Kim  ;  Chi Heon Kim  ;  Chun Kee Chung  ;  Kyung Hyun Kim  ;  Yong Eun Cho  ;  Dong Ah Shin  ;  Youn-Kwan Park  ;  Yunhee Choi 
 JOURNAL OF CLINICAL NEUROSCIENCE, Vol.80 : 100-107, 2020-10 
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Issue Date
Aged ; Cohort Studies ; Conservative Treatment / methods* ; Decompression, Surgical / methods* ; Female ; Humans ; Lumbar Vertebrae / surgery ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function* ; Spinal Stenosis / therapy*
As treated ; Lumbar spinal stenosis ; Non-surgical treatment ; Observational cohort ; Outcomes ; Randomized cohort ; Surgical treatment
Objective: Even if analyzed through meta-analyses or systemic reviews ensued lately, we could say that at least it is inconclusive which of the surgical or non-surgical treatment to lumbar spinal stenosis is better particularly in short to intermediate-term. This study compared non-surgical and surgical outcomes in surgical candidates for lumbar spinal stenosis (LSS). Methods: Surgical candidates for LSS were prospectively screened. Patients were offered the option to be enrolled in a randomized cohort, an observational cohort, or not to participate. Patient-reported outcomes were evaluated at baseline, and at 1, 3, 6, and 12 months. The primary outcomes were measures of pain and functional outcomes such as the Korean version of the Oswestry Disability Index (K-ODI), the EuroQol 5-Dimension instrument (EQ-5D), and 36-Item Short-Form Health Survey (SF-36). Results: One hundred and ten patients were enrolled in the randomized cohort and 37 patients in the observational cohort. Among them, 97 patients received non-surgical treatment, and 50 patients underwent surgical treatment. At 12 months, the non-surgical treatment group had less improvements in the primary outcome measures of back pain (mean change: non-surgery, 2.34 vs. surgery, 3.99), leg pain (2.92 vs. 3.40), K-ODI (5.12 vs. 8.31), EQ-5D utility index (0.19 vs. 0.25), and EQ-5D VAS (9.68 vs. 16.0). Most SF-36 section parameters also showed less improvement in the non-surgical treatment group than in the surgical treatment group throughout the 12-month follow-up. Conclusions: In LSS patients without instability, non-surgical treatment resulted in less pain improvement and functional recovery through 1 year.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Hyun(김경현)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
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