ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
No long term benefit of decompression of a borderline lumbar spinal stenosis level adjacent to a more stenotic index level.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Percutaneous Endoscopic Decompression versus Non-Operative Care for Radicular Pain in the Oldest-Old with Lumbar Stenosis: A Target Trial Emulation Focusing on Pain Relief and Deprescribing.Clinical interventions in aging · 2026Trial
- Targeting the Symptom-Driving Level in Multilevel Lumbar Stenosis Using Unilateral Biportal Endoscopy: A Strategy Reappraisal.Journal of clinical medicine · 2026Article
- Agreement of CT versus MRI in reinvestigation of patients operated for lumbar spinal stenosis. a comparison of surgically and non-surgically treated levels.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Central Canal Stenosis Severity Does Not Predict Residual Leg Pain After Percutaneous Transforaminal Endoscopic Decompression in Frail Elderly Patients: A Propensity Score-Weighted Cohort Study.Journal of pain research · 2026Article
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Authors and funding
14 authors.
Funding
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Abstract
purposeLumbar spinal stenosis (LSS) frequently involves multiple levels of the spine. Whether to perform single-level decompression (SLD) or multi-level decompression (MLD) in patients with at least one borderline stenotic level adjacent to the primary (index) level, remains debated. Short-term follow-up studies show comparable outcomes for both strategies. This study aimed to assess five-year outcomes in patients with adjacent borderline stenosis. MATERIAL: All participants were recruited from the NORDSTEN-SST. Patients with a preoperative adjacent borderline stenosis, defined as Schizas grade B or C, in addition to the index level, were included in the study. The cohort was divided into two groups based on the type of surgical intervention: SLD or MLD. Baseline characteristics and clinical outcomes were recorded for both groups, with follow-up conducted five years postoperatively. Subgroup analysis based on the Schizas grade in the adjacent level were also performed.
resultsOut of 437 patients in the NORDSTEN-SST, the 222 with borderline adjacent stenosis were included. Among these, 114 underwent SLD, while 108 underwent MLD. Baseline characteristics were comparable between groups. Mean change in ODI-score was - 16.0 (95% CI -18.9-12.9) for the SLD group and - 18.6 (95% CI -22.1-15.1) for the MLD group, p = 0.26. Subgroup analyses revealed no significant differences between groups in clinical outcomes or need for subsequent spinal surgeries.
conclusionIn this observational study, five-year clinical outcomes in patients operated for lumbar spinal stenosis with a significant stenotic index level were not influenced by additional decompression of preoperative adjacent borderline stenotic levels.
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