Surgery May Be Best Option for Degenerative Spondylolisthesis

Surgery is an effective tool for treating pain associated with degenerative spondylolisthesis, a new study confirms.

According to study author James Weinstein, DO, MS, professor and chair of the departments of orthopedics at Dartmouth Medical School and Dartmouth-Hitchcock Medical Center, and director of The Dartmouth Institute for Health Policy & Clinical Practice, and his fellow researchers, it has been unclear whether or not surgery actually is more beneficial at providing relief, but this study proves that it is.

The Spine Patient Outcomes Research Trial (SPORT) found “a clear advantage for surgery,” according to Weinstein, who added that patients experienced “faster relief, better function, less pain, and higher satisfaction than those who chose to go the non-surgical route” at two and four years after the surgery was done.

SPORT took data from 607 men and women with spondylolisthesis from 13 medical centers in 11 states, the largest study ever conducted with these particular patients, according to the researchers.

"Until this study, our 'evidence' was anecdotal and based on patient reports,” Weinstein said. “We wanted data-based, scientific evidence that we could share with patients to help them make their decisions about taking an operative vs. non-operative approach,"

The trial examined the “three most common back conditions” that lead to surgery—herniated disc, spinal stenosis, and spinal stenosis with degenerative spondylolisthesis. Participants who were included in the study had to meet certain criteria, which included “nerve pain in the legs, spinal stenosis revealed on cross-sectional imaging, degenerative spondylolisthesis evident in radiograph imaging, symptoms which lasted for at least 12 weeks, and physician confirmation that the patient was a surgical candidate.”

“Our results indicate that in these patients, there was a clear advantage for surgery," Weinstein added.

Findings of the study were published in the June 2009 issue () of the Journal of Bone and Joint Surgery.