Background: Canada has a universal health care system that is funded by the government 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 lumbar disk herniation in Canada as compared to the United States. Methods: Surgical lumbar disk herniation patients enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective 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. Results: The CSORN cohort consisted of 443 patients and the SPORT cohort was made up of 573 patients. Patients in the CSORN cohort were older (p<0.001), and were more likely to be employed (p=0.003). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (87.2% vs. 65.5%, p=0.003) and 1 year (85.6% vs. 69.0%, p<0.0001). The CSORN cohort was a significant independent predictor of patient satisfaction at 1 year. Conclusions: Patients undergoing surgical treatment for lumbar disc herniation in Canada reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States.