COMPARATIVE EFFECTIVENESS OF CONSERVATIVE VERSUS SURGICAL MANAGEMENT OF SPINAL DEGENERATIVE DISEASES

Abstract

The method was systematic in comparing the conservative and surgical treatments in patients with degenerative conditions on the spinal cord and used clinical, functional, and quality-of-life outcome indicators at short-term and long-term follow-ups. We evaluated the severity of pain, indices of disability, neurological status, complication, and patient-reported outcomes. With conservative management, there were significant improvements in pain and functionality of patients with mild to moderate disease whereby the improvement was long-standing and had low rates of complications. Surgery resulted in faster and better improvement of symptoms and functional recovery in patients with severe degeneration or neurological deficiency; nevertheless, it was associated with higher rates of complications and higher use of resources. Prolonged follow up showed that there was a reduction in the differences between groups on a range of outcomes indicating that specific patients had similar functional status.