Surgery Clinical Trial
Official title:
Comparison of the Effect of Lumbar Spinal Manipulation, Physical Therapy and Surgical Management in the Treatment of Lumbar Spinal Stenosis
To compare the effect of lumbar spinal manipulation, physical therapy and surgical management in the treatment of lumbar spinal stenosis.
Low back pain (LBP) is a very common health problem which results in negative impact in daily
life and burden especially in elderly. The global age-standardized point prevalence of LBP in
2010 was estimated to be 9.4%. Among the etiologies of low back pain, lumbar spinal stenosis
is frequently encountered by physicians. In a large observational study, the prevalence of
lumbar spinal stenosis was 23.6% in the general population and higher in patients more than
60 years-old. If untreated, the symptoms may persist in 70% of the patients over the 48-month
observation period. On the other hand, previous studies have shown that surgery is more
effective in pain relief, neurological symptoms and further functional status, however,
conservative treatment still had favorable effect in patients with milder symptoms.
The role of spinal manipulation has been discussed in previous study which compared the
clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica
secondary to lumbar disc herniation. According to this study, the pain, disability and life
quality of both groups in 12-week period had no significant difference that chiropractic
spinal manipulative treatment could be considered as a primary treatment. However, comparison
among the effect of spinal manipulation, physical therapy, and surgery has not been conducted
before. Therefore, the purpose of this study is to compare the effect of spinal manipulation,
physical therapy, and surgery in the treatment of lumbar spinal stenosis.
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