Inflammatory cytokines (IL-6, TNF-α, PGE2, and NO) seem to play a crucial role in hypertrophy and ossification of LF. Degenerated, herniated intervertebral disks, and facet arthrosis may influence LF through inflammatory cytokines and cause hypertrophy and ossification of LF.

Vitamin D deficiency was common in patients with LSS. However, vitamin D status was improved after decompressive surgery, and postoperative 25-OHD level was significantly correlated with surgical outcomes.

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