[Stenosis of the lumbar spine in elderly persons. Surgical decompression]

The degenerative changes in the lumbar vertebral spine frequently appear as encroachment of the lumbar spinal canal. Degenerative changes of the anatomical structures dictate the location of the stenosis, which are divided in central or lateral stenosis of the lumbar spinal canal. According to this localization, more radicular symptoms in a lateral stenosis might be prevalent in contrast to the mixed symptoms of a central stenosis. Operative decompression might be indicated in cases with correlation of clinical symptoms and radiological findings. The operative treatment aims at a satisfactory decompression without creating iatrogenic instability. An additional fusion might be avoided in cases without apparent instability. Adequate operative decompression is most efficient concerning reduction of pain and increasing of walking distance.