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Surgical and nonsurgical treatments for lumbar spinal stenosis

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Abstract

Lumbar spinal stenosis (LSS) is the most common indication for spinal surgery in older adults; however, the efficacy of surgery for LSS as compared to nonsurgical treatments remains unclear. Here, we reviewed numerous studies, including randomized control trails (RCTs), to compare nonsurgical and surgical treatments for LSS. The nonsurgical management of LSS includes medication, epidural injections, physiotherapy, lifestyle modification, and multidisciplinary rehabilitative approaches. Patients with LSS who do not improve after nonsurgical treatments are typically treated surgically using decompressive surgery, which has the strongest evidence base. Although decompressive surgical treatment is associated with modestly successful outcomes, it remains unclear whether decompression combined with fusion surgery results in clinical outcomes that are superior to those following decompression surgery alone. Future RCTs assessing the effectiveness of specific treatments based on high-quality scientific evidence are expected to aid clinical decision-making and improve treatment outcomes for LSS.

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We did not receive grants or external funding in support of our research or preparation of this manuscript. We did not receive payments or other benefits or a commitment or agreement to provide such benefits from any commercial entity.

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    1. Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, 252-0374, Kanagawa, Japan

      Gen Inoue, Masayuki Miyagi & Masashi Takaso

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    1. Gen Inoue
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    2. Masayuki Miyagi
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    3. Masashi Takaso
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    Correspondence to Gen Inoue.

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    Gen Inoue and Masayuki Miyagi have contributed equally to this study.

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    Inoue, G., Miyagi, M. & Takaso, M. Surgical and nonsurgical treatments for lumbar spinal stenosis. Eur J Orthop Surg Traumatol 26, 695–704 (2016). https://doi.org/10.1007/s00590-016-1818-3

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