The two-year study is the first of its kind to investigate the question of surgery vs. an exercise regime for degenerative disc disease. The lead principal investigator is Dr. Isador Lieberman, an orthopedic surgeon at The Toronto Hospital.
"We have no scientific evidence to date to determine which treatment is better for degenerative disc disease," Dr. Lieberman says. "This will be the first study of its kind to specifically examine the question of surgery versus a back-specific exercise program for this condition. As a surgeon, I want to know what the best course of action is for my patients."
The eighty patients enrolled in the study will be randomized either into the surgery group or the exercise group. Those placed in the exercise group will immediately begin an individualized, back-specific program designed to meet their needs.
Patients who are part of the surgery group will undergo a minimally invasive back surgery procedure known as an endoscopic spinal fusion. This surgery will use an implant known as BAK to stop movement of the disc. Patients will follow an activity guideline for six weeks following surgery and then commence an individualized back-specific exercise program.
The exercise programs for both groups will be developed by an athletic therapist collaborating with the study. A second therapist, independent from the study, will conduct the follow-up testing which will include standard tests for endurance, flexibility and strength. Follow-up visits for each group are at three weeks, six weeks, three months, six months, one year and two years.
Collaborating with Dr. Lieberman are Drs. Paul Salo, Demetrius Litwin and Jim Wright of The Toronto Hospital, Mount Sinai and the Hospital for Sick Children, respectively. The study is funded by SpineTech Inc., of Minneapolis.
"This study is a great example of how hospitals are working with industry to combine resources to further patient research and improve patient care," Dr. Lieberman says.
Degenerative disc disease is a disabling and painful disease caused by aging and wear and tear. Injury to the back can also accelerate the disease. The discs are located between the bones of the spine and are described as soft cushions acting as shock absorbers. With their deterioration, movement is extremely painful. Approximately two per cent of the Canadian population has painful degenerative disc disease.
Patients qualifying for the study must be between the ages of 20 and 60 with single level degenerative disc disease (deterioration of one disc) who experience back pain with movement.
The Toronto Hospital is Canada's largest acute care teaching facility with approximately 1200 beds. It has achieved international renown in patient care, teaching and research in its four priority programs: cardiac sciences, neurosciences, transplantation and oncology.
For more information contact Josey Panetta, Senior Media Relations Officer,
The Toronto Hospital, (416) 340-3303.
Return to
The Toronto Hospital Home Page