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As the population ages, primary care clinicians increasingly are encountering older patients with symptomatic lumbar spinal stenosis. The previously published SPORT study included both randomized and nonrandomized comparisons of surgery and nonsurgical treatment (NEJM JW Gen Med Mar 15 2008 and N Engl J Med 2008; 358:794; NEJM JW Gen Med Jul 1 2007 and N Engl J Med 2007; 356:2257). Now, a new analysis of SPORT data focuses on outcomes among the 105 oldest participants (age, ≥80), compared with 1130 younger patients (mean age, 64). Because crossover between surgical and nonsurgical groups was substantial, as-treated analyses were conducted.
In most of the pain and function outcomes at 4 years, surgically treated patients in the older cohort e…