POEMs

Spinal Stenosis: Physical Therapy Before Surgery

 


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Am Fam Physician. 2015 Sep 15;92(6):528.

Clinical Question

Is surgery more effective than physical therapy in patients referred for surgery for spinal stenosis?

Bottom Line

Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients with confirmed spinal stenosis before getting out the scalpel. (Level of Evidence = 1b –)

Synopsis

The investigators enrolled 169 patients (average age: 66 to 69 years) with image-confirmed lumbar stenosis who consented to surgery. This approach to enrollment eliminated many patients, presumably those with milder symptoms. The patients were r

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.



 

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