Spinal decompression improves walking capacity in patients with lumbar spinal stenosis.

Introduction: Lumbar spinal stenosis (LSS) is a degenerative condition causing back and leg pain, limiting walking due to neurogenic claudication. It affects 9-11 % of the population, rising to 47 % in those over 60, with cases expected to increase as the population ages. Non-surgical treatments are considered first-line options, although their effectiveness remains uncertain. Decompression surgery is still commonly performed for severe cases, even though a review comparing conservative treatments with surgical procedures, including spinal decompression, found no clear superiority of surgery. In Denmark, LSS accounts for 35 % of spinal surgeries in adults. Research question: Does spinal decompression improve walking distance and gait speed in patients suffering from LSS? Methods: Consecutive patients scheduled for decompression due to spinal stenosis enrolled at a regional spine centre. Timed walking distance (maximum of 1000m) was performed at baseline and at 3-, and 12 months post-op. Results: One hundred and one patients were included in the study, mean age was 70.7 years, 77 % were female, with 90 % having had symptoms for more than 6 months prior to surgery.Walking distance (123.9m-791.1m, p < .001) and speed (0.91 m/s to 1.17 m/s, p < .001) improved at one year after surgery. Discussion and conclusion: Patients with severe walking impairment caused by spinal stenosis experienced substantial improvement of both walking speed and walking distance at all follow-up time points after undergoing spinal decompression.