In this article, I will discuss lumbar spinal canal stenosis and surgical and conservative treatment.
Lumbar spinal canal stenosis is said to be one of the most common diseases that occur with age. Symptoms such as back pain, numbness and leg pain can be caused by interventions such as surgery, physical therapy, immobilization and injections.As with all of these cases, the question is which treatment method is best? That is the question.The review presented here compares surgical and conservative therapies, although each comes with its own benefits and risks.
The studies
A total of 643 people with lumbar scoliosis were reviewed in five studies comparing surgical and non-surgical treatments.
The average age of participants in all studies was 59 years.
Follow-up periods were studied ranging from 6 weeks to 10 years.
Based on this review, it is not possible to conclude whether surgical or non-surgical treatment is superior for patients with lumbar spinal stenosis.For the side effects reported in three of the five surgical groups, we can report that the impact rate is high, ranging from 10 to 24%.No side effects have been reported for any of the conservative treatment options.Three studies compared spinal surgery with various types of non-surgical treatments.It is difficult for the review authors to draw conclusions from these studies because the nonsurgical treatments were not well described.One study that compared surgical treatment with exercise found no difference in pain.Another study compared surgery with spinal injections and found improved physical function with the injections and improved pain relief with surgery after six weeks.Yet another study compared surgery with non-surgical care using an implantable device. This study reported favorable outcomes of surgery on symptoms and physical function.
Reviewer's Conclusion
We have little confidence in concluding whether surgical or conservative approaches are superior for lumbar spinal stenosis, and we cannot offer any new recommendations to guide clinical practice. It should be noted, however, that the rate of side effects in the case of surgery ranges from 10% to 24%, while no side effects have been reported with conservative treatment. No clear advantages were observed between surgical and non-surgical treatments. These findings suggest that clinicians need to be very careful when informing patients about possible treatment options, especially given that conservative treatment options did not result in the reported side effects. High-quality studies are needed to compare surgical versus conservative care for patients with lumbar scoliosis.
Zaina F, Tomkins-Lane C, Carragee E, Negrini S. Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD010264. DOI: 10.1002/14651858.CD010264.pub2.
Conclusion
It is impossible to conclude which treatment is the best for lumbar spinal stenosis.There have been some reports of side effects with surgical treatments, but none with conservative treatments, so it seems that the results are not positive.This is because some studies have reported side effects of conservative therapy such as spinous process fracture, coronary artery ischemia, and respiratory failure.It may be that the outcome will be better if the choice of treatment is not biased toward any one of them, but rather is evenly distributed.
