Untreated symptomatic lumbar spinal stenosis and health-related quality of life: the locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS).

Purpose: This study compared health-related quality of life (HRQoL) between untreated and conservatively treated patients with symptomatic lumbar spinal stenosis (LSS) using data from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study.

Methods: We retrospectively analyzed HRQoL using the SF-12 survey in patients diagnosed with symptomatic LSS via a self-reported history questionnaire. LSS treatment history was confirmed through physician interviews. The study included untreated (UTG) and conservatively treated patients (CTG). One-to-one nearest-neighbor propensity score matching compared patients receiving and not receiving conservative treatment. Propensity scores were calculated using background data: age, sex, height, weight, smoking, difficulty walking 100 m, urinary incontinence during walking, comorbidities, musculoskeletal disease treatment history, and questionnaires (depression screening, low back pain-specific QoL, self-efficacy regarding falls, physical activity assessment, and the 2008 SF-12).

Results: In 2008, 376 patients were diagnosed with symptomatic LSS. At the 1-year follow-up, 251 were untreated, 144 received conservative treatment, and 11 underwent lumbar spinal surgery. Before matching, overall HRQoL was lower in the CTG than in the UTG at baseline and 1-year follow-up. Mental health scores in the CTG significantly decreased at the 1-year follow-up. After matching, the median change in mental health scores was significantly lower in the CTG than in the UTG.

Conclusion: At baseline and the 1-year follow-up, HRQoL was lower in the CTG compared to the UTG. Additionally, there was no apparent QoL deterioration in the UTG during the 1-year follow-up, even when patients followed their natural medical consultation behaviors.