[Spinal canal stenosis : Widespread disease or just a radiological diagnosis?]

Lumbar spinal canal stenosis primarily affects older individuals over 65 years old and is often associated with typical symptoms, such as spinal claudication. Aside from rare congenital causes, it usually develops secondarily due to age-related changes, such as disc protrusion, facet joint degeneration and ligament hypertrophy. Apart from the typical clinical symptoms, native upright X‑ray images in two planes and magnetic resonance imaging (MRI) are decisive. Patients without relevant neurological deficits should primarily undergo conservative treatment. In cases of pain that cannot be alleviated by conservative approaches, neurological deficits and ineffective conservative treatment the indications for surgical treatment can be justified. A minimally invasive decompression should be strived for whenever possible. A fusion can become necessary in the presence of a clinically relevant instability, stenosis or malalignment.