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Updated: Jan 20, 2026

Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
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Lumbar Spinal Stenosis Represents a Distinct Sagittal Alignment Phenotype Beyond Normal Aging.

Yoji Ogura1, Tatsuya Yamamoto2, Yohei Takahashi2

  • 1Department of Orthopedic Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.

Spine
|January 19, 2026
PubMed
Summary

Lumbar spinal stenosis (LSS) patients exhibit a distinct sagittal alignment profile, differing from normal aging. Decompression surgery offers partial improvement, but residual malalignment persists, suggesting unique LSS structural characteristics.

Keywords:
decompression surgerylumbar lordosislumbar spinal stenosisnormative reference cohortpelvic incidencepelvic tiltpostoperative alignmentsacral slopesagittal alignmentsagittal vertical axisspinopelvic parametersthoracic kyphosis

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Radiographic analysis

Background:

  • Sagittal alignment is well-studied in healthy populations and adult spinal deformity.
  • Sagittal alignment specific to lumbar spinal stenosis (LSS) is under-researched.

Purpose of the Study:

  • Determine if LSS has a distinct sagittal alignment phenotype beyond normal aging.
  • Assess alignment changes after decompression surgery for LSS up to two years.

Main Methods:

  • Retrospective cohort study of 448 patients undergoing decompression for LSS.
  • Compared LSS patients to age- and sex-matched normative data.
  • Measured sagittal parameters preoperatively and at two-year follow-up.

Main Results:

  • LSS patients showed significantly higher SVA and PT, and lower LL, SS, and TK compared to controls.
  • Postoperative alignment improved but did not normalize.
  • Residual malalignment persisted, indicating a distinct LSS alignment phenotype.

Conclusions:

  • LSS is linked to a unique sagittal alignment profile that amplifies age-related changes.
  • Decompression surgery provides partial sagittal alignment improvement.
  • Findings suggest intrinsic structural differences in LSS, necessitating individualized treatment.