Lumbar spinal stenosis (LSS) is a degenerative condition characterized by narrowing of the spinal canal in the lower back, impinging on the spinal nerves and causing symptoms like lower back pain, leg numbness, weakness, and neurogenic claudication (leg pain that worsens with walking or standing and improves with rest or bending forward). It is the most common reason for spinal surgery among individuals over 65 and affects hundreds of thousands annually in the U.S. Many people develop disc degeneration or facet joint overgrowth starting in their 30s, even if asymptomatic.
Diagnosis relies on clinical evaluation (history, physical exam showing balance issues, reflex changes, typical posture) and imaging (MRI/CT).
Conservative management—medication (NSAIDs), physical therapy, epidural injections, lifestyle alterations—is often effective in the short term. Minimally invasive procedures, such as minimally invasive lumbar decompression (MILD), lateral transverse arthrodesis technique (LTAT), or spinal cord stimulation can be used to successfully treat refractory cases. Surgery (like laminectomy) is considered when all other therapies fail; roughly 60–70% of operated patients achieve significant relief, though improvements may decline over time.