Swedish Spinal Stenosis Study

Swedish Spinal Stenosis Study. An RCT Comparing Decompression With Fusion to Decompression Only in Lumbar Spinal Stenosis With or Without Degenerative Olisthesis.

A national randomized multicentre trial (RCT) where decompression is compared with decompression with simultaneous fusion in 245 patients with spinal stenosis on one or two adjacent lumbar levels with or without degenerative olisthesis. The material is stratified for the existence of degenerative olisthesis >3mm. Monitoring is performed with clinical results from patient surveys after 2 and five years, and with radiological follow-up (MRI, CT and plain X-ray) and an objective function test (6 min walking test) after 2 years. The null hypothesis is that there is no difference in results between the two interventions.

Inclusion Criteria:

• Pseudoclaudication in one or both legs and backpain (VAS>30)
• MRI with 1-2 adjacent stenotic segments (area <0.75 mm2)between L2 and sacrum
• Duration of symptoms >6 months
• Informed consent

Exclusion Criteria:

• Spondylolysis
• Degenerative lumbar scoliosis (Cobb angle >20 deg)
• History of lumbar spinal surgery for spinal stenosis or instability
• Stenosis not caused by degenerative changes
• Stenosis caused by herniated disc
• Other specific spinal conditions, Mb Bechterew, malignancy, neurologic disorders
• History of vertebral compression fractures in affected segments
• Psychological disorders where the surgeon considers participation inappropriate(dementia, drug abuse)