Stenosis Surgery Same as Hip Replacement

A new study reveals that patients undergoing lumbar spinal stenosis surgery show the same improvement in quality of life as those who have total hip replacements.

Although spinal stenosis is often thought of as a narrowing of the spinal canal, the condition can occur when there is any mismatch between the size and contents of the spinal canal and adjoining nerve pathways. The spinal cord may be unusually thick, the canal may be inherently narrow, or the canal may have narrowed over time as the result of degenerative changes in the spine.

Depending on the individual and the degree of nerve compression, spinal stenosis may or may not produce symptoms, such as leg pain and numbness or weakness. In severe cases, it can limit an individual's ability to walk or perform normal, everyday activities. In the new study, researchers from the University of Toronto (Canada) reviewed preoperative and one-year postoperative quality-of-life scores in all patients with symptomatic lumbar spinal stenosis who had undergone one- or two-level spinal compression, with or without fusion. These scores were compared with those in a group who received total hip replacements. Age, gender, and severity of degenerative disease were similar in these patients.

Before surgery, the two groups were found to have similar scores on both the physical and mental components of an outcomes tool known as the SF-36. After surgery, the physical component scores improved in both groups, with greater improvement in the hip patients. However, mental component scores improved in the stenosis group only. Overall, improvements in the two groups were similar, the researchers concluded. Similar results were found in trials in Norway and Sweden.

"In appropriately selected patients with pathology that's amenable to surgical intervention, we can generate quality-of-life improvements in the spine that are comparable to those in hip replacement,” said Raja Rampersaud, M.D., of the University of Toronto, who presented the findings at the annual meeting of the North American Spine Society in Philadelphia (PA, USA) in September/October 2005.