Our Summary

This research paper analyzed previous studies in order to compare the effectiveness of two different surgical techniques used to treat lower back pain due to lumbar spinal stenosis (LSS): decompression surgery alone and decompression surgery combined with fusion surgery. LSS is a condition where the spinal canal narrows, putting pressure on the nerves and causing pain.

The researchers looked at outcomes such as back pain, leg pain, disability scores, quality of life, operation time, blood loss during surgery, length of hospital stay, complications, ability to walk, the number of additional surgeries needed, and overall success rates.

After analyzing the data from fifteen studies involving 17,785 patients, they concluded that there was no significant difference in effectiveness between the two surgical techniques. However, they found that adding fusion to the decompression surgery resulted in a longer operation time, more blood loss, and a higher risk of complications.

Therefore, they suggest that the choice of surgical treatment for LSS should be discussed further, as the additional fusion doesn’t seem to provide extra benefits and may increase risks.

FAQs

  1. What are the two surgical techniques analyzed in this research paper for treating lower back pain due to lumbar spinal stenosis (LSS)?
  2. What outcomes did the researchers consider in comparing the effectiveness of decompression surgery alone versus decompression surgery combined with fusion surgery?
  3. Based on this research, what are the potential risks associated with adding fusion to decompression surgery?

Doctor’s Tip

A doctor may advise a patient undergoing spinal fusion to follow post-operative instructions carefully, including proper wound care, physical therapy, and avoiding heavy lifting or strenuous activities. It is important for patients to follow up with their healthcare provider regularly to monitor their recovery progress and address any concerns or complications that may arise. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and proper posture can help support the healing process and prevent future spine issues.

Suitable For

Patients who are typically recommended spinal fusion are those who have not found relief from non-surgical treatments such as physical therapy, medication, and injections. They may have severe lower back pain, leg pain, or weakness that is not improving with conservative treatments. Additionally, patients with conditions such as spinal stenosis, degenerative disc disease, spondylolisthesis, or spinal fractures may be candidates for spinal fusion surgery. It is important for patients to discuss their symptoms, medical history, and treatment options with their healthcare provider to determine if spinal fusion is the right choice for them.

Timeline

Before spinal fusion surgery:

  1. Patient experiences chronic lower back pain, leg pain, and other symptoms of lumbar spinal stenosis.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, and nerve conduction studies to confirm the diagnosis.
  3. Patient tries conservative treatments such as physical therapy, medications, and injections to manage the symptoms.
  4. If conservative treatments are unsuccessful, patient and their healthcare provider discuss the option of spinal fusion surgery.

After spinal fusion surgery:

  1. Patient undergoes pre-operative testing and preparation for surgery.
  2. Patient undergoes spinal fusion surgery, which involves removing the damaged disc and fusing two or more vertebrae together using bone grafts, screws, plates, or cages.
  3. Patient stays in the hospital for a few days to recover and receive post-operative care.
  4. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the spine.
  5. Patient follows up with their healthcare provider for monitoring and management of any complications or ongoing symptoms.
  6. Patient experiences a gradual improvement in symptoms over time, with the goal of reducing back pain and improving quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal fusion surgery?
  2. How long is the recovery time for spinal fusion surgery?
  3. Will I need physical therapy after the surgery?
  4. How long will I need to stay in the hospital after the surgery?
  5. What are the success rates for spinal fusion surgery in treating my specific condition?
  6. Are there alternative treatments to spinal fusion surgery that I should consider?
  7. Will I need additional surgeries in the future if I choose spinal fusion surgery?
  8. How will spinal fusion surgery affect my ability to participate in physical activities or sports?
  9. What can I do to prepare for spinal fusion surgery and improve my chances of a successful outcome?
  10. Are there any long-term effects or complications associated with spinal fusion surgery that I should be aware of?

Reference

Authors: Chang W, Yuwen P, Zhu Y, Wei N, Feng C, Zhang Y, Chen W. Journal: Arch Orthop Trauma Surg. 2017 May;137(5):637-650. doi: 10.1007/s00402-017-2685-z. Epub 2017 Mar 30. PMID: 28361467