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The study by Delitto and colleagues gives options to patients who otherwise may feel back surgery is inevitable. Spinal stenosis is common,1 yet there is no professional consensus on diagnostic criteria or indications for surgery. The label is frequently assigned in MRI reports and may quickly lead to surgery. However, arthritic changes in the lumbar spine are common even among asymptomatic individuals,2 so diagnosis based on the pattern and severity of a patient's symptoms.3 Surgery is an option, but treatment choice depends on a patient's knowledge, preferences and values.
This randomised controlled trial (RCT) compared outcomes for lumbar decompression versus physical therapy (PT) …
Funding Funded by National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal Diseases (NIAMS) grant P60AR062799.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.