NIAMS funds multicenter study of surgical vs. nonsurgical treatment of back pain

Surgical versus nonsurgical treatment of three back disorders will be studied in 1,450 patients at 11 medical centers with funds awarded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the National Institutes of Health (NIH). Researchers at these centers will compare the two treatment approaches in patients who have a herniated (bulging) lumbar disc, spinal stenosis (narrowing of the canal through which the spinal cord passes) or degenerative spondylolisthesis, where a vertebra in the spine slips forward out of place. This project is expected to have a major impact on clinical practice and on the cost of medical services for persons with one of the three back disorders.

The 5-year study, which will cost more than $13.5 million, is being performed under the direction of James N. Weinstein, D.O., M.S., professor in the Department of Community and Family Medicine, Center for the Evaluative Clinical Sciences, and professor of surgery at Dartmouth Medical School. Participating centers include: Case Western Reserve University (Cleveland, Ohio), Dartmouth Medical School (Hanover, N.H.), Emory Spine Center (Decatur, Ga.), the Hospital for Special Surgery (New York, N.Y.), Rothman Institute (Philadelphia, Pa.), Nebraska Spine Surgeons, PC (Omaha, Neb.), Rush-Presbyterian-St. Luke Medical Center (Chicago, Ill.), University of California (San Francisco, Calif.), The Hospital for Joint Diseases (New York, N.Y.), Washington University (St. Louis, Mo.) and William Beaumont Hospital (Royal Oak, Mich.).

Patients enrolled in the study will be randomly assigned to either surgical or nonsurgical treatment. In the nonsurgical group, treatments will be prescribed according to the diagnosis and duration of the condition. Among the nonsurgical treatments included in the study are: 1-3 days of bed rest, physical therapy, home exercise, epidura

Contact: Judith Wortman
NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

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