Our Summary

This research paper involves a study called NORDSTEN spinal stenosis trial, where 437 patients with spinal stenosis (a condition where the spaces within your spine are narrowed which can put pressure on the nerves) were treated with one of three different surgical techniques: Unilateral laminotomy with crossover, bilateral laminotomy, or spinous process osteotomy. All these techniques aim to relieve pressure on the spinal cord or nerves, but they do so in different ways and preserve the midline of the spine - the line running down the middle of the spine.

The goal of the study was to check how well each technique worked after five years. The researchers primarily used a scoring system, the Oswestry disability index (ODI), which measures how much a patient’s back or leg pain affects their ability to manage everyday life. They also used other measures such as leg and low back pain scores, patient’s perception of effect, and the rate of additional spinal surgeries.

The results showed that all three techniques were equally effective based on the ODI and other measures. There were also no significant differences in the rates of subsequent spinal surgery among the groups. So, the study concludes that all three techniques have similar long-term outcomes for patients with spinal stenosis.

FAQs

  1. What is the NORDSTEN spinal stenosis trial about?
  2. What are the three surgical techniques used in the study to treat spinal stenosis?
  3. What were the results of the NORDSTEN spinal stenosis trial?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal decompression is to consider discussing with your healthcare provider the different surgical techniques available for treating spinal stenosis, such as unilateral laminotomy with crossover, bilateral laminotomy, or spinous process osteotomy. Each technique has its own benefits and risks, so it’s important to weigh them carefully and choose the one that best suits your individual needs and preferences. Additionally, make sure to follow your doctor’s post-operative instructions carefully to ensure a successful recovery.

Suitable For

Patients with spinal stenosis who are experiencing symptoms such as back pain, leg pain, numbness, weakness, or difficulty walking are typically recommended spinal decompression. This can include patients who have not responded well to conservative treatments such as physical therapy, medications, or injections. Additionally, patients with severe spinal stenosis that is causing significant compression of the spinal cord or nerves may also be candidates for spinal decompression surgery.

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if they are a good candidate for spinal decompression surgery. This may involve imaging studies such as MRI or CT scans to assess the severity of the spinal stenosis and identify any other underlying spinal conditions that may be contributing to the symptoms.

Overall, patients who are experiencing significant symptoms related to spinal stenosis that are impacting their quality of life and have not responded well to conservative treatments may benefit from spinal decompression surgery.

Timeline

Before spinal decompression, a patient may experience symptoms such as back pain, leg pain, numbness or weakness in the legs, difficulty walking or standing for long periods, and tingling sensations in the legs or feet. These symptoms may worsen over time and can significantly impact a patient’s quality of life.

After undergoing spinal decompression surgery, patients typically experience relief from their symptoms as the pressure on the spinal cord or nerves is reduced. This can lead to decreased pain, improved mobility, and a better overall quality of life. Patients may also undergo physical therapy or rehabilitation to further improve their strength and flexibility after surgery.

Overall, the goal of spinal decompression surgery is to alleviate symptoms and improve the patient’s quality of life by addressing the underlying cause of their spinal stenosis. With proper treatment and follow-up care, patients can expect to see long-term benefits from spinal decompression surgery.

What to Ask Your Doctor

Some questions a patient may want to ask their doctor about spinal decompression include:

  1. What is the specific surgical technique you are recommending for my spinal stenosis? How does it work to relieve pressure on the spinal cord or nerves?
  2. What are the potential risks and complications associated with the recommended surgical technique?
  3. How long is the recovery process after the surgery? What can I expect in terms of pain management and physical therapy?
  4. Will I need to make any lifestyle changes or modifications after the surgery to maintain the results?
  5. Are there any alternative non-surgical treatments or therapies that I should consider before deciding on surgery?
  6. What is the success rate of the recommended surgical technique for patients with spinal stenosis?
  7. How often do patients need additional spinal surgeries after undergoing the recommended technique?
  8. Are there any specific factors about my condition or medical history that may affect the outcome of the surgery?
  9. Are there any specific exercises or activities I should avoid to prevent further damage to my spine after the surgery?
  10. How can I best prepare for the surgery, both physically and mentally?

Reference

Authors: Hermansen E, Indrekvam K, Franssen E, Myklebust TÅ, Austevoll IM, Hellum C, Storheim K, Bånerud IF, Ebbs EK, Aaen J, Banitalebi H, Brox JI, Weber C, Solberg T, Hjulstad A, Brisby H. Journal: Eur Spine J. 2025 May;34(5):1590-1599. doi: 10.1007/s00586-024-08514-0. Epub 2024 Oct 24. PMID: 39448401