Surgery is twice as effective as physical therapy and drugs for relieving pain and improving mobility in one of the most common back problems, according to a new report.
The study, published in this week's New England Journal of Medicine, gives "us more confidence in recommending surgery to our patients," said Dr. Mark J. Spoonamore of University of Southern California's Keck School of Medicine. The recommendation is "not just our gut feeling, but based on a strong scientific foundation."
Dr. Arya Shamie of the University of California, Los Angeles' Geffen School of Medicine added: "This is a great study confirming what doctors have believed all along."
The condition, called degenerative spondylolisthesis with spinal stenosis, occurs when one lumbar vertebra in the back slips forward relative to the one next to it, pinching the spinal cord and producing severe pain in the legs.
The condition affects as many as 600,000 Americans, although only about half of those seek medical treatment and perhaps only a quarter of them now undergo surgery, according to Dr. James W. Weinstein of the Dartmouth-Hitchcock Medical Center in Hanover, N.H., who led the study.
The bulk of the patients are older than 50, and women are six times as likely as men to suffer from it, with African-American women at greatest risk.