One-year follow-up of conservative and surgical treatment results for patients diagnosed with lumbar spinal stenosis

doi:10.5312/wjo.v16.i12.109963

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 16, Issue 12

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (14)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-1) series, Tables (1-4) series.

Item

Count

PDF

HTML

Figures (1-1)

Tables (1-4)

Sum=41

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=21

Dec 18, 2025 (publication date) through Dec 17, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Orthopedics

ISSN

2218-5836

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Clinical Trials Study

World J Orthop. Dec 18, 2025; 16(12): 109963
Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.109963

One-year follow-up of conservative and surgical treatment results for patients diagnosed with lumbar spinal stenosis

Aylin Ayyildiz, Adem Yilmaz, Samet Erinç, Levent Aydin, Hakan Ayyıldız, Figen Yilmaz

Aylin Ayyildiz, Department of Physical Medicine and Rehabilitation, Çam and Sakura City Hospital, İstanbul 34100, Türkiye

Adem Yilmaz, Department of Neurosurgery, Hamidiye Etfal Training and Research Hospital, İstanbul 34100, Türkiye

Samet Erinç, Department of Orthopedics and Traumatology, Medicalpark Hospital, İstanbul 34100, Türkiye

Levent Aydin, Department of Neurosurgery, Medicana International Hospital, Istanbul 34100, Türkiye

Hakan Ayyıldız, Department of Radiology, Çam and Sakura City Hospital, İstanbul 34100, Türkiye

Figen Yilmaz, Department of Physical Medicine and Rehabilitation, Hamidiye Etfal Teaching and Research Hospital, Istanbul 34360, Türkiye

Author contributions: Yilmaz F, Ayyildiz A, Yilmaz A, Ayyıldız H designed research; Ayyildiz A, Erinç S, Aydin L performed research; Ayyıldız H, Ayyildiz A, Erinç S, Aydin L contributed analytic tools; Ayyıldız H, Yilmaz F, Yilmaz A analyzed data; Ayyildiz A, Yilmaz F, Yilmaz A, Ayyıldız H wrote paper.

Institutional review board statement: Ethical approval dated 30.04.2019 and numbered 2373 was obtained from the Ethics Committee of Hamidiye Etfal Training and Research Hospital for the study.

Clinical trial registration statement: Clinicaltrial.gov, No. NCT04379765.

Informed consent statement: The patients were informed about the content, purpose, and application of the study and their informed consent was obtained.

Conflict-of-interest statement: No conflicts of interest/competing interests have been reported by the authors or by any individuals in control of the content of this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Aylin Ayyildiz, MD, Department of Physical Medicine and Rehabilitation, Çam and Sakura City Hospital, No. 2 L G-434 Street, İstanbul 34100, Türkiye. aylin.mrt93@gmail.com

Received: May 27, 2025
Revised: June 15, 2025
Accepted: October 20, 2025
Published online: December 18, 2025
Processing time: 204 Days and 23.2 Hours

Abstract

BACKGROUND

In this aging population, lumbar spinal stenosis (LSS) reduces walking distance and impairs functionality. The definitive treatment is still controversial.

AIM

To assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS, both in the short and long term.

METHODS

This prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria: Surgical and conservative. The conservative group received a supervised physical therapy and exercise program for 45 minutes, five days a week, for one month. The surgery group underwent micro endoscopic decompression surgery based on their LSS levels. Assessments, conducted before treatment and at one-month and one-year intervals, included the participants' walking distance, pain level using the visual analog scale, functionality using the Istanbul low back pain disability index (ILBDI) and Swiss Spinal Stenosis Questionnaire (SSS) Scale, and activities of daily living level using the Nottingham Extended Activities of Daily Living.

RESULTS

The study comprised 40 participants, equally divided into surgical and conservative treatment groups, with no significant demographic differences. After one year, both groups exhibited similar changes in walking distance and pain levels. However, the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS. After one year, the surgical group showed greater functionality, as assessed by ILBDI, and superior improvement in activities of daily living compared to the conservative group.

CONCLUSION

Both treatments showed comparable efficacy in core outcomes (pain, walking distance). However, complementary advantages were observed: Conservative management demonstrated superior improvement in SSS functional subscales, while surgery yielded greater gains in daily living activities and low-back-pain-related disability.

Keywords: Lumbar spinal stenosis; Low back pain; Physical therapy; Surgery

Core Tip: Lumbar spinal stenosis is a common cause of pain and functional limitation in older adults. Surgery is frequently performed, but its long-term superiority over conservative treatments remains controversial. This study found no significant long-term difference between surgical and conservative treatments regarding pain relief, walking distance, and functionality. However, the surgical group showed greater improvements in disability scores. These findings support the use of supervised physical therapy as an effective first-line treatment, potentially reducing the need for surgery.