Spine Surgery Improves Leg Pain More Than Back Pain

Spine surgery improves leg pain more than low back pain (LBP), according to findings of the Spine Patient Outcomes Research Trial (SPORT). The trial, which also found that persons who have diabetes mellitus (DM) experience less relief from spine surgery than those who do not, was the first comprehensive look at the effectiveness of various treatments for LBP and pain that radiates down a patient's leg. Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the SPORT was designed to provide evidence to guide physicians and their patients in treatment choices for common spine conditions.

In a SPORT study of back and leg pain, 32% of patients with spinal stenosis experienced mostly leg pain at the first examination, 26% mostly had back pain, and 42% had leg and back pain equally. Among patients with degenerative spondylolisthesis, 34% had predominant leg pain, 26% had predominant LBP, and 40% had equal pain in the leg and low back. Patients with predominant leg pain had improved significantly more than the LBP groups at 1 and 2 years after surgery. The patients with LBP who had undergone surgery improved significantly more than those who had not, suggesting that surgery offers relief from back and leg pain but more from the latter.

In another SPORT study, 199 patients with DM and 2206 patients without DM were enrolled for treatment of intervertebral disk herniation, spinal stenosis, or degenerative spondylolisthesis. The patients with DM-generally older than those without DM and overweight or obese-did not improve as much as those without DM after surgery and had more surgical complications. For patients with DM who are considering spine surgery, these findings suggest that the risks of surgery may not be worth the benefits.

For more information, visit the NIAMS Web site at http://www.niams.nih.gov. Or, contact the organization at National Institute of Arthritis and Musculoskeletal and Skin Diseases, 1 AMS Circle, Bethesda, MD 20892-3675; telephone: (301) 495-4484; (toll-free): (877) 226-4267; fax: (301) 718-6366.

Problems with/comments about this article? Please send feedback.