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Study Design: Cross-sectional study.

Objective: To compare handgrip strength (HGS), paraspinal muscles' (PSM) volume, and their effects on clinical symptom severity between the patients with sagittal imbalance (SI) and symptomatic lumbar spinal stenosis (LSS).

Methods: A total of 54 paired consecutive patients with SI and LSS were enrolled after propensity score matching.

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