A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis *

Abstract

Lumbar spinal stenosis is the most common indication for spinal surgery, and studies have shown that surgical treatment in selected patients is more successful than conservative measures. This chapter aims to investigate whether fusion surgery as an adjunct to decompression surgery resulted in better clinical outcomes than decompression alone in patients with lumbar spinal stenosis, with or without degenerative spondylolisthesis. A multicenter randomized control trial was conducted. Patients with symptomatic lumbar stenosis were recruited from October 2006 through June 2012 from seven Swedish hospitals. Exclusion criteria were spondylolysis, degenerative lumbar scoliosis, history of previous surgery for lumbar spinal stenosis or instability, stenosis not caused by degenerative change, stenosis caused by herniated disc, other spinal conditions, history of vertebral compression fracture in the affected segments, or psychological disorders. The role of fusion in degenerative spondylolisthesis and spinal stenosis is a hotly debated and controversial topic.