Efficacy Comparison: Surgery and Physical Therapy for LSS Treatment

This essay examines the efficacy of surgery and physical therapy in the treatment of lumbar spinal stenosis (LSS), a condition characterized by spinal canal narrowing and associated back pain. The introduction highlights the increasing prevalence of LSS with an aging population, emphasizing the importance of effective therapies. The discussion section details both surgical (Laminectomy) and physical therapy approaches, including stretching, exercise, and ice therapy. The essay then compares findings from several studies, including a 2015 study with 169 participants, which indicated similar outcomes for both treatments over a two-year period. The conclusion emphasizes that both methods are effective, suggesting that physical therapy should be the initial approach, with surgery reserved for cases where physical therapy is insufficient or not tolerated. The essay concludes by reiterating the need for proper treatment regimens, given the increasing incidence of LSS, and the importance of considering both surgical and non-surgical options based on patient needs.

Running head: EFFICACY OF SURGERY AND PHYSICAL THERAPY IN TREATMENT OF LUMBAR SPINAL
STENOSIS 1
Efficacy of surgery and physical therapy in the treatment of lumbar spinal stenosis
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EFFICACY OF SURGERY AND PHYSICAL THERAPY IN TREATMENT OF LUMBAR SPINAL STENOSIS 2
Introduction
Lumbar spinal stenosis is an anatomical condition in which the spinal canal or the nerve
root foramen is narrowed. It is one of the most disabling condition among people older than 65
years. It is characterized by low back pains, buttocks and neurogenic claudication. With the ever
increasing ageing population, more people may suffer from the condition (Tosteson et al., 2017).
It is therefore important to focus on its therapy. Some of the recommended therapies include
surgical or non-surgical modalities. Within the framework of this essay, there will be a
comparison and contrast on the efficacy between the two.
Discussion
Physical therapy for spinal stenosis involves use of physical means like thorough exercise
or heat so as to lower the pain and allow the patient to gradually return to routine activities.
Physical therapy is conducted by a physical therapist and it involves stretching to lower stress on
joints, exercise to strengthen the muscles and ice therapy to assist in relieving the pain (Tosteson
et al., 2017). Surgery to correct lumbar stenosis is known as Laminectomy and it basically
involves removal of the lamina which forms part of the vertebra so as to widen the spinal canal
to provide room for nerves. During this process, some ligaments and bone spurs may be
extracted. The surgery is carried out by making an incision into the back. There is continued
debate over which method between the two is the most effective in treating the lumbar stenosis
and this calls for extensive research to solve the puzzle.
All the two treatment regimen are effective and there is no one that seems better than the
other. This is according to different studies conducted to establish the most effective between the
two. In one of the studies conducted in 2015 for example where 169 participants were examined

EFFICACY OF SURGERY AND PHYSICAL THERAPY IN TREATMENT OF LUMBAR SPINAL STENOSIS 3
for two years, it was found out that the outcome in both physical therapy and surgery in spinal
stenosis was the same. The study was conducted for 2 years whereby function measurements
were also tracked at baseline of 10 weeks, 6 months and 12 months. The results were similar in
the two groups. This included 82 participants who began with surgery and 82 who started with
physical therapy. In both groups, the increase in function followed similar trajectories from the
baseline onwards. This study was conducted between 2000 and 2007 and the participants were
50 years and above (Lurie et al., 2014). From the study, the researchers concluded that since the
two regimens have the same effectiveness, individuals suffering from LSS should be subjected to
physical therapy and surgery should only be implemented if the patient does not respond.
In another almost similar study by Delitto et al., in 2015, the results were similar. In this
study, results indicated that there is no differences in efficacy between a trial of physical therapy
and simple decompression surgery (Delitto et al., 2015). The study mainly focused on ability to
relieve symptoms and improve the general functioning of the body. In both studies, results from
the Intention to treat analysis indicated that in both treatment regimens, the subjects started
improving at the 10th week and there was marked improvement through 26 weeks (Abdu et al.,
2018). When a comparison to the baseline was made, the results indicated that magnitude of
improvement at the 2 year follow up for the two groups was above the minimal clinically
important differences for measures of function SF-36 physical function. This therefore means
that both the two treatment options have the same efficacy.
Conclusion
Lumbar spinal stenosis is condition where the spinal canal gets narrowed leading to lower
back pains and mostly affects individuals above 65 years. Since there ageing population is
increasing at an alarming rate, there is the need to come up with proper treatment regimens that

EFFICACY OF SURGERY AND PHYSICAL THERAPY IN TREATMENT OF LUMBAR SPINAL STENOSIS 4
have a higher efficacy. The two methods commonly used are surgery and physical therapy. From
the studies, no method has a higher efficacy than the other. Physicians should therefore initiate
physical therapy and surgery should only be implemented when the situation gets out of hand or
if the patient is intolerant to physical exercise.

EFFICACY OF SURGERY AND PHYSICAL THERAPY IN TREATMENT OF LUMBAR SPINAL STENOSIS 5
References
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