New techniques for decompression of lumbar spinal stenosis.

Central and lateral stenoses of the lumbar neural canal are relatively less common causes of chronic pain in the lumbar back and the legs. However, their incidence is much higher than was previously thought. Accurate anatomical diagnosis was difficult until the advent of high resolution computed tomographic scanning. Appropriate decompressive surgery can now be designed and "guided" by the scans and the clinical syndrome. New or highly modified surgical procedures are now being used with good to excellent clinical results in as high as 80% of the cases depending upon the technique chosen. Many of these cases are failed back surgical cases and those whose diagnoses were not established by standard means, e.g., plain films, myelography, low resolution tomography, discography, etc. The good results reported here include patients with pain and disorders of long standing.