{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:47:20Z","timestamp":1785444440193,"version":"3.56.0"},"reference-count":23,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0While the rates of lumbar spinal stenosis (LSS) surgery have increased continuously internationally, the role of fusion surgery in the treatment of LSS has been under debate. We aimed to assess the outcome of LSS surgery at 1 year postoperatively and to compare decompression surgery with or without fusion based on the Finnish national spine register FinSpine data.Methods:\u00a0FinSpine data of surgically treated LSS from 2015 to 2022 was included. The primary outcome was Oswestry Disability Index (ODI), and secondary ones were Visual Analogue Scale for leg and back pain. Predetermined minimal clinically important difference (MCID) for all outcome measures was used to assess the clinical significance of differences in outcomes. Propensity score matching was utilized to ensure that the treatment groups were comparable.Results:\u00a0There were 8,647 LSS patients in the data, of whom 6,751 (77%) were the subject of decompression surgery. Over 90% of patients without spondylolisthesis received decompression alone. At 1-year follow-up, ODI was on average 20.6 (95% confidence interval [CI] 19.3\u201321.9]) for the fusion group and 23.3 (CI 22.5\u201324.0) for the decompression group. Differences in ODI, VAS leg pain, or VAS back pain were below the MCID. The share of patients reaching ODI percentage change score \u2265 30% was 74% (CI 71\u201378) in the fusion group and 66% (CI 63\u201368) in the decompression group.Conclusion:\u00a0Most of the LSS patients experienced significant improvement after LSS surgery. We found no clinical differences between decompression surgery with and without fusion.<\/jats:p>","DOI":"10.2340\/17453674.2025.42849","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T11:14:29Z","timestamp":1739531669000},"source":"Crossref","is-referenced-by-count":5,"title":["1-year results of lumbar spinal stenosis surgery in Finland: a national FinSpine register study"],"prefix":"10.2340","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-8303","authenticated-orcid":false,"given":"Juho","family":"Hatakka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6272-4010","authenticated-orcid":false,"given":"Inari","family":"Laaksonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9883-1256","authenticated-orcid":false,"given":"Joel","family":"Kostensalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keijo T","family":"M\u00e4kel\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6374-9444","authenticated-orcid":false,"given":"Henri","family":"Salo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Pernaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"key":"99670","doi-asserted-by":"crossref","unstructured":"Johnsson K E, Ros\u00e9n I, Ud\u00e9n A. The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 1992: (279): 82-6. PMID: 1534726.","DOI":"10.1097\/00003086-199206000-00010"},{"key":"99671","doi-asserted-by":"crossref","unstructured":"Malmivaara A, Sl\u00e4tis P, Heli\u00f6vaara M, Sainio P, Kinnunen H, Kankare J, et al. Surgical or nonoperative treatment for lumbar spinal stenosis?: A randomized controlled trial. Spine 2007; 32: 1-8. doi: 10.1097\/01.brs.0000251014.81875.6d.","DOI":"10.1097\/01.brs.0000251014.81875.6d"},{"key":"99672","doi-asserted-by":"crossref","unstructured":"Weinstein J N, Tosteson T D, Lurie J D, Tosteson A N A, Blood E, Hanscom B, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med 2008; 358: 794-810. doi: 10.1056\/NEJMoa0707136.","DOI":"10.1056\/NEJMoa0707136"},{"key":"99673","doi-asserted-by":"crossref","unstructured":"F\u00f6rsth P, Micha\u00eblsson K, Sand\u00e9n B. Does fusion improve the outcome after decompressive surgery for lumbar spinal stenosis?: a two-year follow-up study involving 5390 patients. Bone Joint J 2013; 95-b: 960-5. doi: 10.1302\/0301-620x.95b7.30776.","DOI":"10.1302\/0301-620X.95B7.30776"},{"key":"99674","doi-asserted-by":"crossref","unstructured":"Sunderland G, Foster M, Dheerendra S, Pillay R. Patient-reported outcomes following lumbar decompression surgery: a review of 2699 cases. Global Spine J 2021; 11: 172-9. doi: 10.1177\/2192568219896541.","DOI":"10.1177\/2192568219896541"},{"key":"99675","doi-asserted-by":"crossref","unstructured":"van Hooff M L, Jacobs W C, Willems P C, Wouters M W, de Kleuver M, Peul W C, et al. Evidence and practice in spine registries. Acta Orthop 2015; 86: 534-44. doi: 10.3109\/17453674.2015.1043174.","DOI":"10.3109\/17453674.2015.1043174"},{"key":"99676","doi-asserted-by":"crossref","unstructured":"F\u00f6rsth P, \u00d3lafsson G, Carlsson T, Frost A, Borgstr\u00f6m F, Fritzell P, et al. 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A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthop 2015; 86: 523-33. doi: 10.3109\/17453674.2015.1036696.","DOI":"10.3109\/17453674.2015.1036696"},{"key":"99680","doi-asserted-by":"crossref","unstructured":"Copay A G, Glassman S D, Subach B R, Berven S, Schuler T C, Carreon L Y. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 2008; 8: 968-74. doi: 10.1016\/j.spinee.2007.11.006.","DOI":"10.1016\/j.spinee.2007.11.006"},{"key":"99681","doi-asserted-by":"crossref","unstructured":"Fairbank J C. Why are there different versions of the Oswestry Disability Index? J Neurosurg Spine 2014; 20: 83-6. doi: 10.3171\/2013.9.Spine13344.","DOI":"10.3171\/2013.9.SPINE13344"},{"key":"99682","doi-asserted-by":"crossref","unstructured":"Mannion A F, Junge A, Grob D, Dvorak J, Fairbank J C. 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Back pain improvement after decompression without fusion or stabilization in patients with lumbar spinal stenosis and clinically significant preoperative back pain. J Neurosurg Spine 2016; 25: 596-601. doi: 10.3171\/2016.3.Spine151468.","DOI":"10.3171\/2016.3.SPINE151468"},{"key":"99687","doi-asserted-by":"crossref","unstructured":"Srinivas S, Paquet J, Bailey C, Nataraj A, Stratton A, Johnson M, et al. Effect of spinal decompression on back pain in lumbar spinal stenosis: a Canadian Spine Outcomes Research Network (CSORN) study. Spine J 2019; 19: 1001-8. doi: 10.1016\/j.spinee.2019.01.003.","DOI":"10.1016\/j.spinee.2019.01.003"},{"key":"99688","doi-asserted-by":"crossref","unstructured":"L\u00f8nne G, Schoenfeld A J, Cha T D, Nygaard \u00d8 P, Zwart J A H, Solberg T. Variation in selection criteria and approaches to surgery for lumbar spinal stenosis among patients treated in Boston and Norway. 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