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Therapeutics/Prevention
Randomised controlled trial
Surgery and physical therapy likely yield similar outcomes in spinal stenosis
  1. Sohail K Mirza
  1. Department of Orthopaedics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
  1. Correspondence to : Dr Sohail K Mirza, Department of Orthopaedics, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; sohail.k.mirza{at}dartmouth.edu
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http://dx.doi.org/10.1136/ebmed-2015-110220

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    Commentary on: Delitto A, Piva SR, Moore CG, et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial. Ann Intern Med 2015;162:465–73.OpenUrlCrossRefPubMed

    Context

    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.

    Methods

    This randomised controlled trial (RCT) compared outcomes for lumbar decompression versus physical therapy (PT) …

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