Turkish Neurosurgery 2005 , Vol 15 , Num 4
Comparison of Conservative and Surgical Treatment Results in Lumbar Spinal Stenosis
Nurdal PAKER1, Cengiz TÜRKMEN2, Derya BUĞDAYCI1, Demet TEKDÖŞ1, Metin ERBİL1
1İstanbul Physical Therapy and Rehabilitation Training Hospital 2nd PMR Clinic, İstanbul, Turkey
2İstanbul Physical Therapy and Rehabilitation Training Hospital Neurosurgery Department, İstanbul, Turkey
OBJECTIVE: The aim of this study was to compare the results of physical therapy combined with drug treatment and surgical intervention in patients with lumbar spinal stenosis.

METHOD: Patients with lumbar spinal stenosis who were diagnosed clinically and with magnetic resonance imaging were included in the study. Pre- and post-treatment pain severity was evaluated with VAS. Conservative approach consisted of four weeks of physiotherapy, exercises and drug therapy. Surgical intervention consisted of decompression with laminectomy and foraminotomy.

RESULTS: Eighteen of the 19 patients were treated with the conservative approach were followed for a mean period of 40.4 months (18-60 months) and 22 patients with surgical intervention were followed for a mean period of 18 months (4-32 months). One patient from the conservative therapy group did not come to outpatient clinic controls and was dropped out. The most frequent level of canal stenosis was L3–4 in the conservative therapy group and L4–5 in the surgical intervention group. Following treatment, pain was reduced significantly in both groups. There was a statistically significant increase in the walking distance of the surgical treatment group; however, the increase in the walking distance of the conservative treatment group was not statistically significant.

CONCLUSION: Both the conservative treatment and the surgical decompression in lumbar spinal stenosis are effective for long-term pain relief. Therefore the results of surgical treatment were found to be better in functional and symptomatic well being when compared to the results of conservative treatment. Keywords : Conservative treatment, Lumbar spinal stenosis, Surgical procedures

Corresponding author : Nurdan Paker