SPORT shows surgery better than conservative management at eight years

A recent publication published in Spine (Phila Pa 1976). 2014 Jan 1;39(1):3-16 using data from SPORT (Spine Patient Outcomes Research Trial) showed surgical treatment for lumbar disc herniation is associated with significantly greater improvements than non-operative management at eight years follow-up.

Cervical Disc Arthroplasty Is Getting More Insurance Approval

http://bit.ly/H2Nie4

Cervical disc arthoplasty (artificial cervical disc replacement surgery) is now being recognized by more health care insurance companies as standard of care for cervical disc herniation/spondylosis/stenosis with radiculopathy. Seven year data is now available showing its efficacy.

“Spine” study suggests that Lumbar Fusion & Instrumentation are Not Connected to More Adjacent Level Reoperation

In a recent study published in Spine ( http://bit.ly/17d1CqS ), researchers performed a subgroup analysis of the Spine Patient Outcomes Research Trial (SPORT) to determine the risk of same segment or adjacent segment reoperation after lumbar stenosis surgery.
The study included 413 patients who underwent surgery for spinal stenosis, 13 percent of which required reoperation within four years.

“The study concluded that lumbar fusion and instrumentation were not associated with increased rate of reoperation at same level or adjacent levels compared with nonfusion surgery techniques. The only specific risk factor for reoperation after treatment of spinal stenosis was duration of pretreatment symptoms more than 12 months. The overall incidence of reoperations for spinal stenosis surgery was 13%, and reoperations were equally distributed between index and adjacent lumbar levels. Reoperation may be related to the natural history of spinal degenerative disease.” (credits to the authors)

It is feasible that current minimally invasive fusion techniques will further lessen re-operation rates by preservation of supporting tissues and more selective positioning of instrumentation to secure the index level and protect the adjacent levels.