Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |7 April 2015

Surgery Versus Physical Therapy for Treating Lumbar Spinal Stenosis Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • The full report is titled “Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis. A Randomized Trial.” It is in the 7 April 2015 issue of Annals of Internal Medicine (volume 162, pages 465-473). The authors are A. Delitto, S.R. Piva, C.G. Moore, J.M. Fritz, S.R. Wisniewski, D.A. Josbeno, M. Fye, and W.C. Welch.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
×
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
    • What did the researchers find?
    • What were the limitations of the study?
    • What are the implications of the study?
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link
  • CiteULike Link

What is the problem and what is known about it so far?

Lumbar spinal stenosis (LSS) happens when there is narrowing of the space in the spinal canal (center of the spine) or the bony spaces in the spine where the nerves come out of the spinal cord. This narrowing puts pressure on the spinal cord or nerves, which can cause pain, numbness, or weakness of the lower back, thighs, and legs. Some patients have surgery to relieve the pressure on the nerves and spinal cord. Although there are nonsurgical treatments for LSS, such as physical therapy (PT), studies have not clearly shown whether these treatments have the same or different effects than surgery.

Why did the researchers do this particular study?

To compare the effects of surgery with PT for patients with LSS.

Who was studied?

169 patients who had LSS and were candidates for surgery; the patients consented to have surgery before they were invited to join the study.

How was the study done?

Patients with LSS were randomly assigned to have surgery or PT. The PT sessions were held twice a week for 6 weeks and included exercises to increase flexibility of the lower back and legs, leg strength, and knowledge about proper posture. The researchers evaluated the patients' physical function at 10 weeks, 6 months, 1 year, and 2 years.

What did the researchers find?

The PT and surgery groups had the same amount of improvement in physical function at 2 years. The most common complications in the surgery group were delayed wound healing, infection, and repeated surgery. In the PT group, the only complication reported was increased symptoms.

What were the limitations of the study?

Some patients declined to join the study because they did not want to risk not having surgery. During the study, 57% of the patients who were assigned to the PT group crossed over to have surgery; 43% remained and did not have surgery. The study did not include a group that did not receive any treatment.

What are the implications of the study?

A standard program of PT had the same effects as surgery on the physical function of patients with LSS. Patients with LSS should talk with their doctor about the benefits and risks of surgery compared with nonsurgical treatments for their condition.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Surgery Versus Physical Therapy for Treating Lumbar Spinal Stenosis. Ann Intern Med. 2015;162:I–32. doi: 10.7326/P15-9009

Download citation file:

  • RIS (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2018

×
Permissions

Published: Ann Intern Med. 2015;162(7):I-32.

DOI: 10.7326/P15-9009

0 Citations

See Also

Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial
View MoreView Less

Related Articles

Surgery for Lumbar Spinal Stenosis: Informed Patient Preferences Should Weigh Heavily
Annals of Internal Medicine; 162 (7): 518-519
Treating Sepsis Is Complicated: Are Governmental Regulations for Sepsis Care Too Simplistic?
Annals of Internal Medicine; 168 (8): 594-595
Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia Syndrome Treated With Sirolimus
Annals of Internal Medicine; ():
Annals for Educators - 20 March 2018
Annals of Internal Medicine; 168 (6): ED6
View MoreView Less

Journal Club

Guided early deescalation of antiplatelet treatment was noninferior to usual prasugrel care in PCI-treated ACS
Annals of Internal Medicine; 167 (12): JC69
Self-monitoring of blood glucose did not improve HbA1c or QoL at 1 year in non–insulin-treated type 2 diabetes
Annals of Internal Medicine; 167 (8): JC46
In PCI-treated ACS, switching from aspirin + a newer P2Y12 blocker to aspirin + clopidogrel reduced adverse events
Annals of Internal Medicine; 167 (6): JC28
In type 2 diabetes treated with high-dose insulin, liraglutide reduced HBA1c
Annals of Internal Medicine; 165 (8): JC40
View MoreView Less

Related Point of Care

Palliative Care
Annals of Internal Medicine; 168 (5): ITC33-ITC48
Systemic Lupus Erythematosus
Annals of Internal Medicine; 159 (7): ITC4-1
Polymyalgia Rheumatica
Annals of Internal Medicine; 166 (9): ITC65-ITC80
Community-Acquired Pneumonia
Annals of Internal Medicine; 151 (7): ITC4-1
View MoreView Less

Related Topics

Neurology

Neurology.

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Online First RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards

  • Personae Photography Prize
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2018 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×