Geriatric Locomotive Function Scale Assessment of Surgical Treatment Outcomes in Older Lumbar Spinal Stenosis Patients with Locomotive Syndrome Stage Three: Comparing Stage-Based and Minimal Clinically Important Difference-Based Improvements

Background: The 25-item Geriatric Locomotive Function Scale (GLFS-25) is often used to assess locomotive syndrome stage in older adults with lumbar spinal stenosis (LSS). However, locomotive syndrome stage three encompasses a wide score range, potentially masking clinically meaningful improvements. This study aimed to establish the minimal clinically important difference (MCID) for the GLFS-25 and determine whether MCID-based assessment better reflects surgical outcomes than stage-based evaluation.