Long-Term Prognosis of Surgical and Non-Surgical Treatment for Lumbar Spinal Stenosis: A Retrospective Cohort Study

Surgical decompression provides superior early improvement in functional status and pain compared to non-surgical management, with benefits partially maintained beyond five years. However, outcome convergence over time suggests that both approaches can be effective for appropriately selected patients. Prognostic factors identified in this study may guide personalized treatment decisions for patients with LSS. This study suggests an association between surgical decompression and superior initial improvement. However, due to the non-randomized design, these findings must be interpreted with caution.