19,628 operations in NSW for LSS between 2003 and 2013 - A Randomised Placebo-Controlled Surgical Trial of Lumbar Spinal Stenosis Background Surgery for Lumbar Spinal Stenosis What is Lumbar Spinal Stenosis? It is the narrowing of the spinal canal because of degenerative changes of bone or ligaments What are the symptoms of Lumbar Spinal Stenosis? Pain, numbness or fatigue in the legs when walking that decreases with sitting down or bending forward 19,628 operations in NSW for LSS between 2003 and 2013 Traditional surgery involves removing the bone and ligaments that are compressing the nerves in the spinal canal SUcceSS Trial- World’s First Randomised Placebo-Controlled Surgical Trial of Lumbar Spinal Stenosis What’s Involved In The Trial? Surgeon and Study Team Confirms Patient Is Eligible   STEP Spinal Surgeon Completes Assessment 1 -Leg pain -50+ years old -Not improved with Physio STEP   2   Patient Has Surgery Group 1 receives traditional decompression surgery 50/50 chance of being in Group 1 or Group 2   Group 2 receives placebo surgery-which is traditional surgery, except with no decompression (bone removal) We Follow Patients in Both Groups for 2 Years and Compare Outcomes STEP 3 Main comparison between groups will be at 3 months   Walking ability Function and disability Quality of life Any adverse events Costs Why is the trial important?   Provide the first high-quality evidence for the benefit of removing the bone in improving outcomes   We now know a better way to treat lumbar spinal stenosis!!! Improved understanding of how to manage lumbar spinal stenosis REFERENCES Images sourced from: http://en.seiran.or.jp/lcs.html https://www.pinterest.com.au http://www.clipartpanda.com http://blog.ebinfoworld.com http://nextreflexdc.com http://mzayat.com Machado G, et al. Trends, complications, and costs for hospital admission and surgery for lumbar spinal stenosis. Spine;42(22):1337-1743 Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med 2008;358:818–25.