[Significance of simultaneous fusion and surgical decompression in lumbar spinal stenosis]

In a prospective study 45 patients with clinically relevant spinal stenosis of the lumbar spine were randomized in three groups. Group 1 underwent isolated decompression without fusion, group 2 had decompression and selected fusion, and group 3 underwent fusion of all decompressed segments. Patients with previous surgery of the lumbar spine or obvious instability, such as spondylolisthesis, were excluded from the study. The results were dominated by the relevant clinical improvement in the symptoms of spinal stenosis in all three groups. There were no statistical significant differences in the clinical results between the patients with and without fusion. We conclude that in the absence of obvious segmental instability, no fusion is required for decompressive surgery in degenerative lumbar spinal stenosis.