In Patients with Lumbar Spinal Stenosis, Adding Fusion Surgery to Decompression Surgery Did Not Improve Outcomes at 2 Years.

Abstract

Forsth P, Olafsson G, Carlsson T, Frost A, Borgstrom F, Fritzell P, Ohagen P, Michaelsson K, Sanden B. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016 Apr 14;374(15):1413-23. ### Question: In patients with lumbar spinal stenosis, with or without degenerative spondylolisthesis, does adding fusion surgery to decompression surgery improve clinical outcomes at 2 years? ### Design: Randomized (allocation concealed)*, unblinded, controlled trial with 2 years of follow-up. Swedish Spinal Stenosis Study (SSSS). ClinicalTrials.gov NCT01994512. (*Information provided by author.) ### Setting: 7 hospitals in Sweden. ### Patients: 247 patients 50 to 80 years of age (mean age, 67 years; 67% women) who had lumbar spinal stenosis with ≤2 adjacent stenotic segments, a back pain score of >30 of 100 on a visual analog scale (VAS), pseudoclaudication in 1 or both legs, and symptoms for >6 months. Exclusion criteria were stenosis due to a herniated disc or nondegenerative changes, spondylolysis, degenerative lumbar scoliosis, …