Use of surgery for the management of lumbar spinal stenosis

Summary Lumbar spinal canal stenosis is a clinical condition that often results in symptoms such as radicular pain or neurogenic claudication. In some instances, the clinical manifestations of spinal stenosis can be quite debilitating and the condition is one of the more common reasons for spinal surgical consultation, particularly in those over the age of 65 years. A variety of treatment options are regularly employed in the management of lumbar spinal stenosis, ranging from nonoperative therapies, such as physical therapy and epidural steroid injections, to surgical intervention. Evidence-based recommendations for treatment include an initial trial of conservative management followed by surgical intervention if patient symptoms persist. The surgical intervention for standalone lumbar spinal stenosis that is most supported by the current literature is a simple lumbar decompression. Further investigations need to be conducted in order to characterize the comparative effectiveness of surgery and specific nonoperative treatment algorithms.