Functional Outcomes in Patients with Symptomatic Lumbar Degenerative Disease Treated Non-Surgically

Objective: To describe differences in initial and follow-up visit disability scores in patients with lumbar spine degenerative disease treated non-surgically.

Methods: Records for 53 patients (36 women, 17 men), including 12 high-risk patients (8 diabetics, 4 smokers) undergoing conservative treatment for lumbar spine disorders between September 2009 and March 2010 were reviewed. The mean difference between initial and follow-up visit Oswestry Disability Index (ODI) scores was determined.

Results: The difference between initial and follow-up ODI for all patients was 4.40% (± 12.24%, p: 0.01). Differences for female and male patients were 3.16% (± 11.43%, p: 0.10) and 7.03% (± 13.77%, p: 0.05) respectively. High risk and low risk patient cohorts showed improvements of 3.03% (± 12.12%, p: 0.42) and 4.76% (± 12.39%, p: 0.01) respectively. Overall, 32 of 53 patients showed improvement in ODI, 38% of which improved their score by >12%. 6 of 53 patients pursued elective spinal surgery, 33% of which had actually improved their ODI with conservative therapy.

Conclusion: Conservative therapy for patients with lumbar spine degenerative disease resulted in lower pain and disability, as evidenced by improvements in the Oswestry disability index. Men showed statistically significant greater improvements in pain and disability than did women undergoing similar treatment. Low risk patients showed greater improvements than patients considered high risk. An appreciable number of patients in our study pursued elective spinal surgery, some despite improvements with conservative therapy. Overall, the number electing surgery was much less than in previous studies.