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April 7, 2010

The Increasing Morbidity of Elective Spinal Stenosis Surgery: Is It Necessary?

JAMA. 2010;303(13):1309-1310. doi:10.1001/jama.2010.402

Surgical treatment of older patients with severe and protracted symptoms from neurogenic claudication or radicular pain syndromes can provide rapid improvement. The most common clinical presentation, spinal stenosis with primary radicular pain, can be effectively treated with lumbar decompression alone. The use of the operative microscope, minimal dissection, and rapid postoperative mobilization, as developed over the last 20 years, has decreased surgical morbidity. Large observational and controlled studies have shown that most patients with spinal stenosis can realize large and durable gains in pain relief and functional improvement with this procedure, despite multilevel vertebral involvement, advanced age, and common comorbid medical conditions.1-3