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Second SPORT study shows surgery advantage for spinal stenosis and slipped vertebra

Hanover, NH In one of the three most common back conditions for which patients seek treatment, surgery proved to have substantially better results than non-surgical remedies, according to Dartmouth-led research published in the May 31 New England Journal of Medicine. The paper is the second in a series detailing the findings of the Spine Patient Outcomes Research Trial (SPORT), a seven-year, $21 million national study funded by the National Institutes of Health.

In cases of degenerative spondylolisthesis with spinal stenosis, a condition that affects six times as many women as men and is especially prevalent among African-American women, surgery was twice as effective as non-surgical approaches in reducing pain and restoring functionality for patients.

This publication follows the release of earlier SPORT findings in November, which looked at patients seeking treatment for disk herniation with sciatica. For that condition, the difference in outcomes between the surgical and non-operative groups was less.

"The SPORT study was undertaken with one purpose in mind: to give physicians and patients solid information that would allow them to make informed choices when faced with a decision of how to treat their back condition," said lead author Dr. James N. Weinstein, professor and chair of orthopaedics at Dartmouth Medical School and Dartmouth-Hitchcock Medical Center.

Although back surgeries are among the most common surgical procedures performed in the United States, until SPORT, there had been only a few very small controlled trials to gauge their effectiveness.

Degenerative spondylolisthesis (DS) is the forward slippage of one lumbar vertebra on the one below it. It generally occurs after age 50. It is not clear why it occurs more often in African-American women. Although DS alone generally causes no symptoms, in some cases it can result in spinal stenosis-narrowing of the spinal canal which causes press
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Contact: Deborah Kimbell
deborah.kimbell@dartmouth.edu
603-653-0887
Dartmouth Medical School
30-May-2007


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