Significant back pain should not be contraindication for decompression alone

NEW ORLEANS — Surgeons should not rule out decompression alone as treatment in patients who present with significant back pain and lumbar spinal stenosis since decompression can significantly reduce back and leg pain, a speaker said here.

Standalone decompression can significantly reduce pain symptoms for up to 1 year postoperatively, according to a presentation by John J. Knightly, MD, at the Congress of Neurological Surgeons Annual Meeting.

“Patients with lumbar stenosis and clinical back pain do have improvement after decompression only, which should not serve as a contraindication,” he said.

Knightly and colleagues analyzed the results of decompression only in 745 patients with 1-year postoperative follow-up data. About two-thirds of the patients underwent a one-level or two-level decompression procedure.

Patients who had four levels decompressed presented with different levels of pain compared to other patients in the study, however they also experienced pain reduction at 1 year, Knightly said.

The investigators found that patients presented with more severe leg pain than back pain experienced better relief of their symptoms at all time points. All of the patients studied experienced statistically significant relief of their pain at 3 months postoperatively.

At about 1 year after surgery, back pain symptoms started to regress, but relief of leg pain remained stable, Knightly noted. – by Robert Linnehan

Reference:

Crawford III CH, et al. Paper #212. Presented at: Congress of Neurological Surgeons Annual Meeting; Sept. 26-30, 2015; New Orleans.

Disclosure: Knightly reports no relevant financial disclosures.