The Operative versus Conservative Approaches in the Management and Treatment of Lumbar Spinal Stenosis

Abstract

Background: Lumbar Spinal stenosis is the narrowing of the spinal canal at any lumber level. Lumbar spinal stenosis has multiple severities and both conservative and operative treatment options. The objective of the current study was to compare the results of operative and conservative approaches in spinal stenosis treatment. Methods: This cross-sectional study was conducted from January 2019 to June 2019. The data was collected from different hospitals in Lahore (Ittefaq, General, Jinnah, and Hameed Latif). Participants (n=121) of both genders, pre-diagnosed with Lumbar spinal stenosis and symptoms history of 10 weeks (confirmed on imaging) were included. Interventions were decompressive surgery and conventional conservative management. The outcome measures were body pain, functional activities, and the Oswestry Disability Index. An independent sample t-test was used to compare the results between the two groups. A p≤ 0.05 was considered statistically significant. Results: The patients undergoing surgery had statistically significant (p=0.00) advantages of surgery compared to the non-surgical group at 3 months. The 25(36%) of patients remained the same after conservative treatment with 51(72%) having pain radiation and 47(66%) with neurological deficit. The effect of treatment for body pain was 7.8 (95%CI, 8.6, 6.9), physical function −1.3 (95%CI, −0.6, −2.2), and Oswestry Disability Index was −3.4 (95%CI, −2.7, −4.1). Conclusion: Patients who had surgery of spinal stenosis showed marked improvements in body pains, functional activities, and Oswestry disability index compared to conservatively treated. Patients, health care providers, and other stakeholders may get benefit from the findings of this study.