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Surgery Improves Spondylolisthesis Outcomes

Surgical patients have greater long-term improvements compared to nonoperative patients

MONDAY, June 8 (HealthDay News) -- In patients with degenerative spondylolisthesis and associated spinal stenosis, those who are treated surgically have significantly better outcomes after four years than those who are treated nonoperatively, according to a study published in the June issue of the Journal of Bone & Joint Surgery.

James N. Weinstein, D.O., of the Dartmouth Medical School in Lebanon, N.H., and colleagues studied outcomes in a randomized cohort of 304 patients who were assigned to receive surgery or nonoperative care, and in an observational cohort of 303 patients. In both cohorts, a majority of patients eventually received surgery.

After four years, the researchers' adjusted analysis of the combined randomized and observational cohorts showed that surgery was associated with advantageous treatment effects of 15.3 for bodily pain and 18.9 for physical function. They also found that surgery was associated with a net deficit of 14.3 for the Oswestry Disability Index.

"Early advantages (at two years) of surgical treatment in terms of the secondary measures of bothersomeness of back and leg symptoms, overall satisfaction with current symptoms, and self-rated progress were also maintained at four years," the authors conclude.

At least one author reported a financial relationship with Medtronic.

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