Longitudinal Changes in Swiss Spinal Stenosis Questionnaire Scores in Surgically and Conservatively Managed Patients with Lumbar Spinal Stenosis

AIM: This pilot study aimed to evaluate longitudinal SSSQ symptom-severity and physical-function trajectories in surgically and conservatively managed patients with lumbar spinal stenosis, with secondary assessment of 6-month treatment satisfaction and demographic and clinical associations.
MATRERIAL and METHOD: A total of 70 patients were included in this prospective observational pilot study. Thirty-five patients underwent surgery for severe stenosis, neurogenic claudication, progressive neurological deficit, or failed conservative care; 35 received conservative treatment for mild-to-moderate stenosis without progressive deficit or according to preference/contraindication. Conservative management included nonsteroidal anti-inflammatory drugs, structured physiotherapy, stretching and strengthening exercises, and education. SSSQ symptom severity and physical function were assessed at baseline, day 7, and 6 months. Treatment satisfaction was evaluated at 6 months.
RESULTS: Baseline demographic features and SSSQ scores were similar, whereas Schizas grade differed by allocation. Symptom severity improved in both groups, with greater improvement after surgery (median change, 1.8 vs. 0.9; p<0.001) and a significant group × time interaction (p<0.001). Physical function also improved in both groups, but change magnitude was similar (median change, 0.4 vs. 0.4; p=0.986), with no significant interaction (p=0.406). Satisfaction was higher after surgery (100.0% vs. 45.7%; p<0.001). In the conservative cohort, satisfaction status was not associated with different symptom or function trajectories. Sex, age, and symptom duration were not associated with 6-month outcomes; BMI correlated only with conservative-group satisfaction.
CONCLUSION: Both treatment pathways were associated with 6-month SSSQ improvement. Surgical management was associated with greater symptom relief and higher satisfaction, whereas physical-function improvement was comparable between groups.