Lumbar Spine Decompression vs. Fusion
STUDY DEMONSTRATES A SIMPLE DECOMPRESSION IS AS EFFECTIVE, CHEAPER AND SAFER IN STANDARD CASES OF LUMBAR SPINAL STENOSIS WHEN COMPARED TO LUMBAR FUSION
Two studies recently published in the New England Journal of Medicine compared surgical outcomes in patients with spinal stenosis. They compared laminectomy alone (decompression of neural structures) versus decompression with spinal fusion. The results demonstrated that decompression alone provided improvement in back pain and leg pain comparable to patients who also had a fusion. The concern for instability that has led to fusions in the past did not appear to be a significant problem after decompression without fusion.
Reports indicate that between 2002 and 2007, there has been a 15-fold increase in the rate of spinal fusion. Lumbar fusion surgery is very common in Northeast Indiana. This study documents that two years after surgery, there is little difference in outcomes between patients having treatment with laminectomies alone as compared to those with laminectomy and fusion. Dr. Forsth indicated that a simple decompression is as effective, cheaper and safer in standard cases of lumbar spinal stenosis. This study will hopefully provoke more scrutiny of the use of lumbar fusion procedures considering the lack of benefit documented in these studies.
References:
1. Forsth, et. al., N Engl J Med 2016;374:1413-1423. Click this link to read the entire ARTICLE.
2. Ghogawala, et. al., N Engl J Med 2016;374:1424-1234. Click this link to read the entire ARTICLE.
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