25-Year study reveals which back surgery patients really need fusion

This study looked back at 25 years of medical records from 246 patients aged 50+ with lumbar spinal stenosis (a condition that narrows the spine and causes leg pain). Researchers compared outcomes of a less invasive surgery (tubular decompression, sometimes with nerve treatment) versus a more involved fusion surgery (TLIF). The goal was to see who needed the bigger operation and whether the simpler approach works well long-term. No new treatments were given—this was purely an analysis of past data.