A Pathway for the Diagnosis and Treatment of Lumbar Spinal Stenosis

Lumbar spinal stenosis is a prevalent condition with varied presentation. Most common in older populations, symptoms typically include back, buttock, and posterior thigh pain. Diagnosis is typically based on physical examination and clinical history, but confirmed on imaging studies. Nonsurgical management includes nonsteroidal anti-inflammatories, physical therapy, and epidural injections. If nonoperative management fails or patient presentation involves worsening symptoms, surgical intervention, most commonly in the form of a laminectomy, may be indicated. Recent literature has demonstrated improved pain and functional outcomes with surgery compared with conservative treatment in the middle to long term.