[Clinical aspects, pathophysiology and surgical treatment of lumbar spinal stenosis]

All the forms of spinal stenosis and spondylosis and some cases of lumbar disc displacement are considered as part of a degenerative process with a starting point in regressive changes of the disc. This leads to instability of the motion segment, which explains the dynamics of the pathophysiology and of the troubles of lumbar spinal stenosis, including the intermittent neurogenic claudication. Signs, symptoms and radiological findings of the unstable lumbar spine relating to spinal stenosis are discussed. Finally, we point out that the right surgical procedure has to solve the disturbances of root-compression and unstable spine as well. We describe a procedure which we prefer as the safest and most efficient, using selected decompression and translaminar joint screws.