Background: Canada has a universal health care system while the United States utilizes a combined public and private payer system. The purpose of this study is to investigate whether there are differences in clinical outcomes between those surgically treated for spinal stenosis in Canada as compared to the United States. Methods: Surgical lumbar spinal stenosis patients treated in Canada that were enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective multicenter registry were compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Spine-related patient reported outcomes (PROs) were compared at 3 months and 1 year post-operatively. Results: The CSORN cohort consisted of 432 patients and the SPORT cohort was made up of 278 patients. The CSORN cohort had a higher proportion of patients with a symptom duration greater than 6 months (92.3% vs. 58.3%, p<0.0001). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (p=0.003) and 1 year (p<0.001). Conclusions: Patients undergoing surgical treatment for lumbar spinal stenosis in Canada (CSORN cohort) reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States cohort (SPORT) despite having longer durations of symptoms prior to surgery.