Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis
Authors: Alfonse T. Masi, Sam Betts
Journal: Annals of Internal Medicine (2015)

Letters1 September 2015Surgery Versus Nonsurgical Treatment of Lumbar Spinal StenosisAlfonse T. Masi, MD, DrPH and Sam Betts, PT, DPT, MOMTAlfonse T. Masi, MD, DrPHFrom University of Illinois College of Medicine at Peoria and Midwest Orthopaedic Center, Peoria, Illinois.Search for more papers by this author and Sam Betts, PT, DPT, MOMTFrom University of Illinois College of Medicine at Peoria and Midwest Orthopaedic Center, Peoria, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5129-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Delitto and colleagues (1) conclude that surgical decompression yielded effects similar to those of a PT regimen among LSS surgical candidates. The authors recommend decision-making conversations between patients and health care providers, as has been previously stated (2).Data to guide providers and patients in complex judgments about LSS were not specified and have not been conclusive (2, 3). Treatment of this condition was described as a balancing act needing an expansive research agenda (2). Randomized trials show average efficacy of therapy and do not reveal different clinical subgroups within a broad spectrum of disease (4). Individual ...References1. Delitto A, Piva SR, Moore CG, Fritz JM, Wisniewski SR, Josbeno DA, et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial. Ann Intern Med. 2015;162:465-73. [PMID: 25844995] doi:10.7326/M14-1420 LinkGoogle Scholar2. Deyo RA. Treatment of lumbar spinal stenosis: a balancing act. Spine J. 2010;10:625-7. [PMID: 20620984] doi:10.1016/j.spinee.2010.05.006 CrossrefMedlineGoogle Scholar3. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, et al; SPORT Investigators. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008;358:794-810. [PMID: 18287602] doi:10.1056/NEJMoa0707136 CrossrefMedlineGoogle Scholar4. Feinstein AR. Twentieth century paradigms that threaten both scientific and humane medicine in the twenty-first century. J Clin Epidemiol. 1996;49:615-7. [PMID: 8656219] CrossrefMedlineGoogle Scholar5. Irwin ZN, Hilibrand A, Gustavel M, McLain R, Shaffer W, Myers M, et al. Variation in surgical decision making for degenerative spinal disorders Part I: lumbar spine. Spine (Phila Pa 1976). 2005;30:2208-13. [PMID: 16205348] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Illinois College of Medicine at Peoria and Midwest Orthopaedic Center, Peoria, Illinois.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0317. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSurgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Anthony Delitto , Sara R. Piva , Charity G. Moore , Julie M. Fritz , Stephen R. Wisniewski , Deborah A. Josbeno , Mark Fye , and William C. Welch Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Steven J. Barrer Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Peter A. Robertson , William R. Sears , and John E. Cunningham Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Anthony Delitto , Sara R. Piva , Charity G. Moore , and William C. Welch Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Anthony Delitto , Sara R. Piva , Charity G. Moore , and William C. Welch Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Peter A. Robertson , William R. Sears , and John E. Cunningham Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis Steven J. Barrer Metrics 1 September 2015Volume 163, Issue 5Page: 397KeywordsPatientsQuality of lifeRandomized trialsResearch assessmentResearch quality assessmentSpineStenosisStiffnessSurgeonsSurgery ePublished: 1 September 2015 Issue Published: 1 September 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...