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Therefore, the comparative effectiveness and selected healthcare resource utilization of patients undergoing decompression with or without fusion surgery at 3\u00a0years follow-up was assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using observational data from the Lumbar Stenosis Outcome Study and a target trial emulation with index trial benchmarking approach, our study assessed the comparative effectiveness of the two main surgical interventions for lumbar degenerative spondylolisthesis\u2014fusion and decompression alone in patients with lumbar degenerative spondylolisthesis and spinal canal stenosis. The primary outcome-measure was change in health-related quality of life (EuroQol Health Related Quality of Life 5-Dimension 3-Level questionnaire [EQ-5D-3L]); secondary outcome measures were change in back\/leg pain intensity (Numeric Rating Scale), change in satisfaction (Spinal Stenosis Measure satisfaction subscale), physical therapy and oral analgesic use (healthcare utilization).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>153 patients underwent decompression alone and 62 had decompression plus fusion. After inverse probability weighting, 137 patients were included in the decompression alone group (mean age, 73.9 [7.5] years; 77 female [56%]) and 36 in the decompression plus fusion group (mean age, 70.1 [6.7] years; 18 female [50%]). Our findings were compatible with no standardized mean differences in EQ-5D-3L summary index change score at 3\u00a0years (EQ-5D-3L German: 0.07 [95% confidence interval (CI), \u2212\u20090.25 to 0.39]; EQ-5D-3L French: 0.18 [95% CI, \u2212\u20090.14 to 0.50]). No between-group differences in change in back\/leg pain intensity or satisfaction were found. Decompression plus fusion was associated with greater physical therapy utilization at 3\u00a0years follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Decompression alone should be considered the primary option for patients with lumbar degenerative spondylolisthesis and spinal stenosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-024-08495-0","type":"journal-article","created":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T12:01:39Z","timestamp":1726920099000},"page":"4281-4291","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Fusion versus decompression alone for lumbar degenerative spondylolisthesis and spinal stenosis: a target trial emulation with index trial benchmarking"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0116-574X","authenticated-orcid":false,"given":"Ines","family":"Unterfrauner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mu\u00f1oz Laguna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Serra-Burriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob M.","family":"Burgstaller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilker","family":"U\u00e7kay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazda","family":"Farshad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar A.","family":"Hincapi\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,21]]},"reference":[{"issue":"5","key":"8495_CR1","doi-asserted-by":"publisher","first-page":"682","DOI":"10.31616\/asj.2020.0472","volume":"14","author":"BH Lee","year":"2020","unstructured":"Lee BH, Moon SH, Suk KS, Kim HS, Yang JH, Lee HM (2020) Lumbar spinal stenosis: pathophysiology and treatment principle: a narrative review. 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Mu\u00f1oz Laguna reports grants from the European Cooperation in Science and Technology (COST) and the Graduate Campus of the University of Zurich outside the submitted work. Serra-Burriel reports grants from the European Commission\u2019s H2020 and EiT Health programmes outside of the submitted work. Farshad reports being stock owner of Moving Spine AG outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}