Surgery for Spinal Stenosis

SUcceSS: SUrgery for Spinal Stenosis – a randomised placebo-controlled trial

Background

Lumbar spinal stenosis (LSS) is a common and debilitating condition that primarily affects individuals over 50. It results from degenerative changes in the structures surrounding the spinal canal—such as the intervertebral discs, facet joints, and ligaments—that lead to a narrowing of the central lumbar spinal canal. People with LSS often experience pain, numbness, or weakness in one or both legs, which worsens with standing or walking but is relieved by sitting or bending forward.

When symptoms do not improve with conservative treatments like medication or physiotherapy, surgery is often recommended. Decompression surgery, such as a laminectomy or laminotomy, involves removing bone and ligament tissue that contribute to the narrowing of the spinal canal. While some individuals experience symptom relief following surgery, strong evidence supporting the efficacy of this approach is still lacking.

Aim

This project aims to evaluate the efficacy, safety and cost-effectiveness of decompression surgery for people with LSS. 

Research Methodology

The SUcceSS Study is conducted as a placebo-controlled randomised trial where people are randomly allocated to decompression surgery or to placebo surgery (usual decompression surgery procedures without bone or ligament removal). Self-reported outcomes associated with disability, walking capacity, symptoms, impact on daily living activities, quality of life, and healthcare usage will be collected every three months for two years.

The trail currently recruits from 11 Hospital sites in NSW and Victoria: Austin Hospital, Cabrini Research, Concord Repatriation General Hospital, Liverpool Hospital, Mater Hospital, Prince of Wales Hospital, Prince of Wales Private Hospital, Sydney Adventist Hospital, Sydney Southwest Private Hospital, The Wollongong Hospital, Wollongong Private Hospital.

Current Status

Currently recruiting – expected study completion 2027.