This study indicated that 21% of LSS patients underwent surgery within 3 years of initial
diagnosis. Surgery skews toward the healthier and younger patients. Overall, 78% of LSS surgeries
were performed in the year of diagnosis, 13% in the second, and 9% in the third. Although laminectomies
and laminotomies were the most frequently performed procedures across all years, a higher
percentage of fusions were performed in addition to laminectomy or laminotomy in the second or third
years after diagnosis than in the first year. The 3-year Medicare payments were $49,624 in the surgery
cohort in comparison with $36,691 in the nonsurgery cohort. Patients who underwent a laminectomy/
laminotomy alone incurred significantly lower Medicare payments ($42,293) than those who had
fusion alone ($57,171) or laminectomy/laminotomy plus fusion ($63,555).