Contemporary management of symptomatic lumbar spinal stenosis.

Lumbar spinal stenosis is a common cause of impaired quality of life and diminished functional capacity in the elderly. Due to the advance of noninvasive imaging modalities, spinal stenosis is becoming more frequently identified, and has become the most frequent cause for spinal surgery in patients older than 65 years. Despite the ubiquitous nature of this condition, considerable controversy exists regarding the preferred treatment. Level I evidence that compares the effectiveness of surgical and nonsurgical treatment is lacking. The Spine Patient Outcomes Research Trial, a study that evaluates the common surgical treatments for the lumbar spine, has addressed this deficiency and is discussed in this article.