Early postoperative recovery of gait efficiency after lumbar decompression: three-month quantitative biomarker assessment.

BACKGROUND

Degenerative lumbar spine disorders impair gait and alter mobility as a result of neural compression and compensatory mechanics. While decompression surgery is effective for pain relief, evidence of functional outcome improvement in the short-term remains limited. PURPOSE: To evaluate the effects of lumbar decompression surgery on spatiotemporal gait parameters, multi-joint kinematics, and patient-reported outcomes three months postoperatively using three-dimensional motion analysis.

METHODS

Thirty-two patients (mean age 69.9 years) with symptomatic lumbar degenerative disease underwent three-dimensional motion analysis one week preoperatively and three months postoperatively. Spatiotemporal gait parameters and multi-joint kinematics were quantified using a 10-camera motion capture system and synchronized force plates. Patient-reported outcomes included the Oswestry Disability Index (ODI), PROMIS Physical Function and Pain Interference, and the Tampa Scale of Kinesiophobia (TSK). Pre- versus postoperative differences were analyzed with mixed-effects linear regression.

RESULTS

At three months, ODI, PROMIS Physical Function, PROMIS Pain Interference, and TSK scores all improved significantly (all p < 0.01). Walking speed increased by 11%, while stride length increased bilaterally by 7% (all p < 0.01). Step width narrowed (p < 0.01), and single-support stability improved (p < 0.05). Kinematic analysis demonstrated reduced compensatory neck and thoracic motion (p < 0.01), increased pelvic and hip mobility (p < 0.01), and bilateral gains in knee and ankle range of motion (p < 0.01).

CONCLUSIONS

Lumbar decompression produces measurable, clinically meaningful improvements in disability, gait efficiency, and coordinated multi-joint mobility as early as three months after surgery. These results highlight the ability of surgical intervention not only to relieve pain and other neurologic symptoms but also to restore upright posture, normalize biomechanics, and enhance functional independence. Incorporating gait analysis into routine spine practice provides objective biomarkers of recovery that extend beyond patient-reported outcomes, offering a powerful tool to guide surgical evaluation, tailor rehabilitation, and optimize long-term patient outcomes.