Skip Navigation LinksHome > August 2012 - Volume 20 - Issue 8 > Degenerative Lumbar Spinal Stenosis: Evaluation and Manageme...
Journal of the American Academy of Orthopaedic Surgeons:
doi: 10.5435/JAAOS-20-08-527
Review Article

Degenerative Lumbar Spinal Stenosis: Evaluation and Management

Issack, Paul S. MD, PhD; Cunningham, Matthew E. MD, PhD; Pumberger, Matthias MD; Hughes, Alexander P. MD; Cammisa, Frank P. Jr MD

Collapse Box

Abstract

Degenerative lumbar spinal stenosis is caused by mechanical factors and/or biochemical alterations within the intervertebral disk that lead to disk space collapse, facet joint hypertrophy, soft‐tissue infolding, and osteophyte formation, which narrows the space available for the thecal sac and exiting nerve roots. The clinical consequence of this compression is neurogenic claudication and varying degrees of leg and back pain. Degenerative lumbar spinal stenosis is a major cause of pain and impaired quality of life in the elderly. The natural history of this condition varies; however, it has not been shown to worsen progressively. Nonsurgical management consists of nonsteroidal anti‐inflammatory drugs, physical therapy, and epidural steroid injections. If nonsurgical management is unsuccessful and neurologic decline persists or progresses, surgical treatment, most commonly laminectomy, is indicated. Recent prospective randomized studies have demonstrated that surgery is superior to nonsurgical management in terms of controlling pain and improving function in patients with lumbar spinal stenosis.

© 2012 American Academy of Orthopaedic Surgeons

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.

Login
or

Article Level Metrics