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Morphologic changes in the spinal canal were quantified using the change in midsagittal canal diameter (\u0394CD) and central canal area (\u0394CCA) on MRI, which were standardized to the Z-score and summed to define the SIS. Functional improvement was evaluated using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and Z-standardized changes across five domains were aggregated to compute the QIS. Associations between SIS, QIS, postoperative satisfaction, and low back pain improvement (\u0394NRS\n                      <jats:sub>LBP<\/jats:sub>\n                      ) were examined using Spearman\u2019s correlation and the Mann\u2013Whitney U test. ROC analysis assessed the discriminative ability of QIS, while multivariate logistic regression identified independent predictors of satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SIS demonstrated strong correlations with \u0394CD (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.864,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and \u0394CCA (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.849,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), confirming its structural measurement validity, but showed no significant association with satisfaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.197) or \u0394NRS\n                      <jats:sub>LBP<\/jats:sub>\n                      (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212\u20090.046,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.645). QIS was moderately correlated with \u0394NRS\n                      <jats:sub>LBP<\/jats:sub>\n                      (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2212\u20090.432,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and was significantly higher in satisfied patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). ROC analysis showed that QIS predicted 1-year satisfaction with an AUC of 0.745 (95% CI, 0.608\u20130.861), sensitivity of 68.9%, and specificity of 81.8%. In multivariable logistic regression, only \u0394NRS\n                      <jats:sub>LBP<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041) and postoperative NRS\n                      <jats:sub>LBP<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) remained independent predictors of satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SIS and QIS provide complementary information on structural and functional recovery after LLIF. QIS demonstrated a moderate association with satisfaction, whereas residual pain remained the dominant determinant. These indices should be considered exploratory and require external validation, psychometric testing, and prospective multicenter studies before routine clinical use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-025-09595-1","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T16:04:32Z","timestamp":1764173072000},"page":"3549-3563","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disparity between early radiographic decompression and one-year patient satisfaction after single-level LLIF: proposal of the structural improvement score (SIS) and QOL improvement score (QIS)"],"prefix":"10.1007","volume":"35","author":[{"given":"Akihiko","family":"Hiyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Katoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"9595_CR1","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1007\/s00586-023-07619-2","volume":"32","author":"R Amaral","year":"2023","unstructured":"Amaral R, Pokorny G, Marcelino F, Moriguchi R, Pokorny J, Barreira I, Mizael W, Yozo M, Fragoso S, Pimenta L (2023) Lateral versus posterior approaches to treat degenerative lumbar pathologies-systematic review and meta-analysis of recent literature. 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