Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 230-237, December 2009

Evidence-Based Treatment of Lumbar Spinal Stenosis

  • Andrew P. White, MD

      Affiliations

    • Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress reprint requests to Andrew P. White, MD, Department of Orthopaedics, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
  • ,
  • Todd J. Albert, MD

      Affiliations

    • Department of Orthopaedic Surgery, Thomas Jefferson University and Hospitals, The Rothman Institute, Philadelphia, PA

Lumbar spinal stenosis is a common cause of leg and back pain. It typically affects individuals beyond 60 years of age. This group is expanding. The current segment of 60 to 80-year-old individuals also has higher functional expectations and is more active than previous generations. As such, there is growing demand for effective treatment. In the USA Medicare population, rates of surgery for spinal stenosis have been increasing. Geographic trends in treatment have been inconsistent. For these reasons, the demand for high quality evidence regarding treatment of this disorder has risen. This article briefly reviews the evidence regarding diagnosis and nonoperative management, as well as the best outcome measurement tools to evaluate this disorder. It then reviews several of the best evidence studies regarding the utility of surgical and nonsurgical treatment for lumbar spinal stenosis.

Keywords: lumbar spinal stenosis, evidence based medicine

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PII: S1040-7383(09)00070-7

doi:10.1053/j.semss.2009.08.006

Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 230-237, December 2009