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The Lumbar Adjacent Segment Stenosis Trial
Sponsor: Oslo University Hospital
Summary
The goal of this clinical trial is to learn if there are differences in the effectiveness of decompression surgery alone versus decompression combined with extended fusion in patients with a previous lumbar spinal fusion who now present with symptoms of lumbar adjacent segment stenosis (LASS). The main questions it aims to answer are: * Does decompression alone differ from decompression combined with extended fusion with regard to clinical outcomes two years after surgery? * Are there any clinical or radiological characteristics that can predict better or worse outcomes two years after surgery? * Are there any differences between the treatment groups in terms of health economics? Researchers will compare decompression surgery alone versus decompression combined with extended fusion to see if there are any differences in treatment effect. Participants will: * Be randomized to one of the two surgical procedures * Visit the clinic four times postoperatively (at three months, 1, 2 and 5 years) for checkups and tests * Respond to questionnaires before surgery, and three months, 1, 2 and 5 years postoperatively
Official title: The Lumbar Adjacent Segment Stenosis (LASS) Trial
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
192
Start Date
2026-08
Completion Date
2032-10
Last Updated
2026-06-26
Healthy Volunteers
No
Interventions
Decompression alone
Patients allocated to decompression alone will be offered mid-line preserving decompression technique with the use of a vision-enhancing aid (microscope or magnifying glasses).
Decompression with extended fusion
Patients allocated to decompression with extended fusion will be offered decompression with the use of vision enhancement (microscope or magnifying glasses). The procedure for the extended fusion will involve bilateral pedicle screws with autologous bone transplant and/or bone substitutes. The use of an interbody device (cage) or not and decompression technique will be at the discretion of the surgeon. Bone grafts should be placed in the interbody device and either posteriorly and/or anteriorly to the interbody device. Autologous bone can be placed in the intervertebral space without a cage if it is not feasible e.g., due to a too narrow intervertebral disc space. Alternatively a posterior or posterolateral bone grafting can be performed.
Locations (3)
Innlandet Hospital Gjøvik
Gjøvik, Norway
Oslo University Hospital HF
Oslo, Norway
University Hospital of North Norway
Tromsø, Norway