Surgical Versus Non-surgical Management of Lumbar Spinal Stenosis

Abstract

Lumbar spinal stenosis is a common degenerative disorder affecting the lumbar spine. It is most commonly associated with facet arthropathy and hypertrophied ligamentum flavum, with a small subset due to large acute disc herniations. Patients may present with a wide variety of neurological signs and symptoms, ranging from asymptomatic presentation to neurogenic claudication, and in the most severe form, cauda equina syndrome. Methods of diagnosis include careful history and physical examination, along with magnetic resonance imaging. Non-surgical management includes physical therapy, pain management, and epidural steroid injections. Surgical treatment includes lumbar laminectomy with or without fusion. A review of the causes and treatment options for lumbar stenosis is described in this manuscript.