European Spine Journal

, Volume 20, Issue 7, pp 1174–1181 | Cite as

Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial

  • Pär Slätis
  • Antti MalmivaaraEmail author
  • Markku Heliövaara
  • Päivi Sainio
  • Arto Herno
  • Jyrki Kankare
  • Seppo Seitsalo
  • Kaj Tallroth
  • Veli Turunen
  • Paul Knekt
  • Heikki Hurri
Original Article


We randomised a total of 94 patients with long-standing moderate lumbar spinal stenosis (LSS) into a surgical group and a non-operative group, with 50 and 44 patients, respectively. The operative treatment comprised undercutting laminectomy of stenotic segments, augmented with transpedicular-instrumented fusion in suspected lumbar instability. The primary outcome was the Oswestry disability index (ODI), and the other main outcomes included assessments of leg and back pain and self-reported walking ability, all based on questionnaire data from 85 patients at the 6-year follow-up. At the 6-year follow-up, the mean difference in ODI in favour of surgery was 9.5 (95% confidence interval 0.9–18.1, P-value for global difference 0.006), whereas the intensity of leg or back pain did not differ between the two treatment groups any longer. Walking ability did not differ between the treatment groups at any time. Decompressive surgery of LSS provided modest but consistent improvement in functional ability, surpassing that obtained after non-operative measures.


Spinal stenosis Surgical treatment Non-operative treatment Randomised controlled trial 



Supported by the Finnish Office for Health Care Technology Assessment and the participating hospitals.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Pär Slätis
    • 1
  • Antti Malmivaara
    • 2
    Email author
  • Markku Heliövaara
    • 3
  • Päivi Sainio
    • 3
  • Arto Herno
    • 4
  • Jyrki Kankare
    • 5
  • Seppo Seitsalo
    • 1
  • Kaj Tallroth
    • 1
  • Veli Turunen
    • 4
  • Paul Knekt
    • 3
  • Heikki Hurri
    • 1
  1. 1.ORTON Orthopaedic Hospital, Invalid FoundationHelsinkiFinland
  2. 2.Centre for Health EconomicsNational Institute for Health and WelfareHelsinkiFinland
  3. 3.National Institute for Health and WelfareHelsinkiFinland
  4. 4.Department of Orthopaedic SurgeryKuopio University HospitalKuopioFinland
  5. 5.Department of Orthopaedic and Trauma Surgery (JK)Helsinki University HospitalHelsinkiFinland

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