Spinal Stenosis: Surgery or Physical Therapy?

Below are two good pieces - one is an article reviewing the research on surgery, specifically spinal fusions, in the treatment of spinal stenosis. The second is a slideshow demonstrating treatment techniques we often employ here for stenosis. Research shows these are extremely beneficial for many patients. Another good thing is they are non-invasive and much less costly!

Press Releases

FOR IMMEDIATE RELEASE

CHOOSE BACK SURGERY AT YOUR OWN RISK

Fusion surgeries found to have increased risk of death; patients should choose safer alternatives.Tallahassee, Florida, April 7, 2010 — Patients with low back pain from spinal stenosis are increasingly being exposed to dangerous surgeries. The Journal of the American Medical Association (JAMA) has just reported an alarming increase in complex spinal surgery for lumbar spinal stenosis. In just five years, from 2002 to 2007, the number of complex fusion surgeries to treat lumbar (low back) spinal stenosis soared from a rate of 1.3 per 100,000 to 19.9 per 100,000. The study showed that life-threatening complications occurred in 5.6% of patients having complex spinal fusions. Patients who had complex fusions had longer hospitalizations, higher rates of re-hospitalization, and three times the rate of serious complications such as heart attack and stroke. These surgeries continue despite little medical consensus on whether or not these procedures are helpful or should even be used in the management of lumbar spinal stenosis.
 
"This study supports what we have been seeing in our clinics for years," said Dr. Bob Rowe, President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT). "Older adults are seeking care from physical therapists following significant back surgeries and they frequently have problems that weren't there prior to surgery and yet they still have back and leg pain. We hope this finally sounds the alarm and stops the madness that is going on in surgical spine care." Dr. Rowe cautions that patients should be aware that these surgeries are extremely risky and put your life in danger and that you may not be any better off after the procedure."
 
Fortunately there is good news for healthcare consumers as a previous randomized clinical trial demonstrated that patients with Lumbar Spinal Stenosis report significant improvement after physical therapy, with the greatest gains occurring in patients who received manual physical therapy, exercise, and a progressive body-weight supported treadmill walking program. Rowe noted that, "it just make sense to try physical therapy first, which is a low cost, low risk, and most importantly effective treatment for chronic low back pain due to lumbar spinal stenosis." Consumers should actively seek care from a qualified physical therapist for their low back complaints.

SLIDESHOW: CLICK LINK BELOW (VERY GOOD INFO!)
http://tinyurl.com/stenosisRCT