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The natural course of untreated DLSS is largely unknown. For the acute DLSS decompensations, the main concern remains the opportunity and timing of surgery, i.e. does emergency decompression improve the neurological prognosis? This question continues to be controversial, and we\u2019ve tried to clarify it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 85 consecutive patients who underwent surgery for decompensated DLSS between January 2020 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients presented with motor deficit (84.7%) and\/or genital-sphincter dysfunction (25.9%). Surgical procedures included decompression alone (77.6%), decompression with discectomy (18.8%), or decompression with arthrodesis (3.5%). Complete neurological recovery was observed in 53 patients (62.4%) by the first follow-up visit (mean 4.6 months), while 32 patients (37.6%) had persistent neurological sequelae at final FU (mean 11.8 months). No significant association was found between neurological recovery and surgical timing, regardless of intervention within 48\u00a0h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.529), 7 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.391), 15 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.213), or 1 month (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.435). Additionally, neither the degree of stenosis on MRI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.147), initial deficit severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06), patient age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.410), nor number of muscles involved (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.328) were significantly associated with recovery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that urgent surgical intervention for decompensated DLSS does not significantly improve neurological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-025-09272-3","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:52:24Z","timestamp":1757551944000},"page":"5614-5623","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decompensation of degenerative lumbar stenosis: do patients need immediate surgery?"],"prefix":"10.1007","volume":"34","author":[{"given":"Marie","family":"Duigou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis-Marie","family":"Terrier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexia","family":"Planty-Bonjour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Destrieux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilyess","family":"Zemmoura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Fran\u00e7ois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mourad","family":"Aggad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aymeric","family":"Amelot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"9272_CR1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.spinee.2007.10.033","volume":"8","author":"WC Watters","year":"2008","unstructured":"Watters WC, Baisden J, Gilbert TJ et al (2008) Degenerative lumbar spinal stenosis: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis. 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The authors have no financial disclosures to report. In addition, all patients gave their informed consent for any medical and scientific investigations. This paper has not been published previously, is not under consideration for publication elsewhere, and we acknowledge that, if accepted, this paper will not be published elsewhere in the same form, in English or in any other language, without the written consent of the publisher.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}