The AUC values of ligamentum flavum thickness and expression quantity of TNF-α, TGF-β1, and IL-1α in the identification of moderate to severe LSS were 0.835, 0.742, 0.890, and 0.891, and the cut-off values were 6.62, 94.66, 80.89, and 50.55, respectively. Here, TNF is linked to Leigh syndrome.