Science In Brief

Chiropractic Litterature Review

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The Study:   Results of lumbar spine surgery: a postal survey.          
      

The Facts:

  1. a. The authors stated that. "No studies had been published regarding the results of lumbar spine surgery in a population-based setting in Finland."
  2. In order to study the results they sent out questionnaires to patients who had undergone surgery for either spinal stenosis, lumbar disc herniations or instability in the lumbar spine.
  3. They looked at the results of these questionnaires from 537 patients.
  4. 67% of these patients had undergone disc surgery while 17% had decompression for stenosis and the final 16% had spinal stabilizing surgery.
  5. The authors noted that the numbers were low for patients who were pain free: 9% for those who underwent disc surgery, 6% in the decompression group and only 1% of those who had spinal stability surgery.
  6. The study showed 70% and 74% of the decompression and stabilizing surgery groups respectively still had constant or daily pain.
  7. Disc surgery patients fared better as 51% reported being pain free or having only occasional pain.
  8. It should be noted that the average age of the disc surgery patients was the youngest of the three groups with an average age of 42 while the patients who underwent decompression for stenosis was the oldest at an average age of 55.
  9. The authors called this outcome in regards to the disc surgeries as follows: "Our study confirmed a good outcome for lumbar disc operations...."
 Take Home:
Outcomes for lumbar disc surgery were better than those for decompression for stenosis or spinal stabilizing surgeries. In the disc surgery patients 51% were pain free or had only occasional pain which the authors of the study felt was a good result.
Reviewer's Comments:
Let me see if I can make a comparison that I like. "Compared to a billiard ball, I have a great amount of hair." Yes, the disc surgeries had better outcomes than the other surgeries studied, but these surgeries are complicated, expensive and have the potential for very real complications. Am I glad they exist for the times when they are needed? Absolutely! This study underscores the need for chiropractors to give the best care possible in order to reduce, as much as possible, the need for spinal surgery.
Reviewer: Roger Coleman DC
Editor's Comments: Success rates of 6% for spinal stenosis decompression and 1% for lumbar instability. Hmmmm. Those are two good figures to remember when counseling your patients.
Editor: Mark R. Payne DC
Reference: Jarvimaki V, Juurikka L, Vakkala M, Kautiainen H, Haanpaa M.Results of lumbar spine surgery: a postal survey. Scandinavian Journal of Pain 6 (2015) 9-13
Link to Abstract: No abstract in PubMed

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