The goal of the Maine Lumbar Spine Study is to determine the long term outcomes of surgical and nonsurgical treatment of two common lumbar spine conditions -- herniated intervertebral disc and degenerative spine stenosis. This study will extend follow-up of over 500 currently enrolled patients to ten years from their initial enrollment. For patients with disc herniation and sciatica, there will be a focus on work-related outcomes including disability compensation and work status. Analyses will also determine if outcomes of surgery and non-operative therapy begin to merge as the only other long-term study has indicated. Long term outcomes of patients with spinal stenosis will determine if the initial preferable outcomes from surgery are maintained or begin to decline. Analyses will also focus on long-term functional status, competing morbidity and symptom recurrence. Over 500 patients with sciatica and stenosis were enrolled in a prospective cohort study between 1990 and 1992. They were treated surgically or non-operatively and have completed annual outcomes questionnaires. This study continues the long-term follow-up and analyses that have been established in a prior AHCPR Patient Outcome Research Team project studying lumbar spine conditions from 1989 -1998. (University of Washington, Richard A. Deyo, PI). Previously developed and validated questionnaires will be completed by these patients through ten years from initial enrollment. This study will provide information about the long term symptoms, function, quality of life and satisfaction with outcome of care of these common disabling conditions. Additional analyses will focus on the relation of rates of surgery to patient outcomes, relationships of disability insurance and workers compensation to long-term outcomes and predictors of long-term improvement.
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