Outcomes Of Decompression and Fusion in Degenerative Lumbar Spinal Stenosis: A Short-Term Retrospective Cohort Study

Abstract

Background: Degenerative lumbar spinal stenosis (DLSS) is a prevalent cause of pain and disability, increasingly affecting younger populations. While surgical decompression is the standard of care, the necessity of adjunctive instrumentation remains controversial. This study evaluates the functional and radiographic outcomes—specifically objective walking capacity—of non‑instrumented decompression and posterolateral fusion (PLF) in a cohort of 50 patients. Methods: Fifty symptomatic DLSS patients (31 males, 19 females) refractory to conservative care underwent decompression with non-instrumented PLF using autologous graft. Functional outcomes were assessed using the Oswestry Disability Index (ODI). Additionally, objective functional impairment was measured via a standardized treadmill walking test to determine Pain-Free Walking Distance (PFWD) preoperatively and at 16 weeks postoperatively. Complications, MRI pathology, and return‑to‑work rates were analysed. Results: The study demonstrated significant functional recovery. Mean ODI improved from a baseline of 56.1% to 15.4% at 16 weeks (p