Posted on 01/23/2023 3:53:02 PM PST by ConservativeMind
For patients with spinal stenosis, operative treatment is associated with lower risk of death and lower costs over two years, compared with nonoperative treatment, suggests a study.
Patients with spinal stenosis experience narrowing of the spinal canal and compression of spinal nerves, causing back pain, leg pain, and other symptoms. In some patients, stenosis is related to degenerative spondylolisthesis, referring to "slipped" vertebrae often resulting from spinal degeneration.
Operative treatment of spinal stenosis can include the use of a laminectomy to decompress the spinal canal, a spinal fusion to stabilize the spine, or a combination of both. Nonoperative treatment can include use of medications, steroid injections, and physical therapy.
Spine surgery has been shown to be cost-effective in reducing pain and restoring function. Many patients experience improved quality of life and mobility following surgery.
The researchers analyzed data on 61,534 Medicare patients with spinal stenosis alone and 83,813 with stenosis and spondylolisthesis. Among these patients, 37% of those with stenosis alone and 52% of those with stenosis and spondylolisthesis were managed operatively; the most common procedures were laminectomy and spinal fusion, respectively. In both groups, the average age was about 73 years.
However, in most comparisons, the actual two-year risk of death was higher in the nonoperative group. For example, among patients with stenosis alone, mortality rates were 3.7% for nonoperative treatment versus 2.5% for laminectomy, as assessed in matched cohorts. For patients with spondylolisthesis, mortality rates were 2.3% for nonoperative treatment versus 1.3% for laminectomy and fusion. In adjusted analyses, the relative risk of death was 28% lower in operatively managed patients.
Among patients with spinal stenosis and spondylolisthesis, Medicare costs were lower with surgical treatment. For example, the average two-year costs were $47,667 for patients who underwent a laminectomy compared with $68,890 for those who were nonoperatively managed.
(Excerpt) Read more at medicalxpress.com ...
Okay.
Not much of a percentage difference and any doctor will state case by case basis so percentages mean very little.
It is debilitating. Period. My Dr says “you don’t want the surgery..” After reading this I am not so sure.
I had back surgery for spinal stenosis. I got a lot of relief from the worst leg pain, but I am left dealing with other areas of pain. It could be so much worse.
I’m glad I received the procedure, but I don’t plan on any additional back surgery except as last resort.
With any ‘fix-it’ kind of surgery, you gain something through science and you lose something in natural movement. My posture is not as good now. I tend to lean to the right when standing unless I decide to straighten up. It was still worth it, to be rid of the firey leg pains at night.
My brother had this surgery some years ago. It had gotten to where he couldn’t walk, his legs would go numb if he tried. What a difference it made, he can do everything again. He just turned 70 last month.
Yeah well I don’t know about that, I’ve known a couple of people who have had that sort of surgery and were not happy with the outcome to say the least.
My brother said it hurt like hell, but eventually the pain went away, and he can do everything he used to before the stenosis set in. He described it as being like carpal tunnel in one’s back.
Not a bad analogy. Mine is debilitating, plus I have a slipped disc to boot.
I hope you can get some relief from it.
Best to you.
I get Medicaid this year.
My doctor has already told me that I need surgery.
For now I use a thc/CBD balm on My lower back.
At least I can sleep.
I have bilateral lumbar stenosis. My pain management doctor told me if I lost weight my condition would improve without surgery. That was the impetus I needed; I’m down 100 pounds from 300 and although I have some pain, it’s nowhere near what it was.
That’s great. I’m glad you were able to lose all that weight.
I wish you luck in keeping it or most of it off.
Some people can do it, when the diet is not extremely different than the normal way they usually eat.
BFLR
Yes, and not carrying things anymore is also great therapy. Only the lightest packages and bags.
It’s hard to get used to but works wonders.
I keep telling people we weren’t meant to walk upright. The spine is still trying to catch up with us.
So far, so good. It took me about a year and a half. Gotta replace bad eating habits with good ones
Did they control for suicide amongst the non-operatives? It may just be the case that the decision not to surgically treat a ruptured disc leads to an increase in suicides, having otherwise nothing to do with the condition itself... Probably shouldn't imply your risk of death is greater because you didn't get the surgery. Some would say it was your lack of faith.
Not me though! It just looks like it's a statistical mistake to me.
Thanks, I do PT 3x a week including traction, that helps but the workout helps even more, and my PT, the owner of the business, is fantastic.
Thanks.
BKMK.
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