[CME: Lumbar spinal stenosis]

Spinal stenosis can be found in up to 80 % of individuals aged over 70 years. However, about 20 % of asymptomatic individuals demonstrate signs of spinal stenosis on MRI. The pathomechanism of central spinal stenosis is predominantly related to degenerative changes. Those eventually result in a progressive compression of the cauda equina. Patients who exhibit mild to moderate symptoms should undergo multimodal conservative treatment, such as patient education, pain medication, physiotherapy and epidural injections. Surgery should be evaluated in patients with severe symptoms, especially if conservative treatment fails after 3–6 months of trial. Clinically relevant motoric deficits or symptoms of cauda equina syndrome remain absolute indications for surgery.