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These authors’ goal was to document the benefit, or lack thereof, of surgery for symptomatic lumbar spinal stenosis in an intention-to-treat, randomized trial. They studied two groups of patients: 289 who were randomized to surgery or conservative care, and 365 who were in an observational cohort. However, by the final 2-year follow-up, only 67% of patients assigned to surgery had been operated on, and 43% of assigned to nonsurgical (conservative) treatment had had surgery. In the observational cohort, 219 patients chose surgery, and 96% of these had surgery within 2 years.
The primary outcomes, assessed by questionnaire, were bodily pain on the Medical Outcomes Study 36-item Short-Form General Health Survey and physical function on a modifi…