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Neurosurgery1739 papers

Spinal stenosis

Last edited: 4/23/2026

Overview

Lumbar spinal stenosis (LSS) is a condition characterized by the narrowing of the spinal canal in the lumbar region, leading to nerve compression and symptoms such as lower back pain, leg pain, and neurogenic claudication. 328

Diagnosis

  • Clinical Presentation: Lower back pain, leg pain, and neurogenic claudication (pain relieved by flexion). 3
  • Imaging Studies: MRI is preferred for detailed visualization of spinal canal narrowing, nerve root compression, and disc degeneration. 128
  • Grading: Utilize the Japanese Orthopaedic Association (JOA) score for assessing severity and functional impact. 22
  • Management

  • Non-Surgical Treatments:
  • - Physical therapy focusing on flexibility and strengthening exercises. 22 - Epidural steroid injections for pain relief. 22
  • Surgical Interventions:
  • - Decompressive Surgery: Laminectomy, laminotomy, and minimally invasive techniques like endoscopic decompression. 151360 - Stabilization Procedures: Transforaminal lumbar interbody fusion (TLIF), percutaneous endoscopic lumbar interbody fusion (PE-TLIF), and hybrid surgeries combining decompression and fusion. 5101149
  • Adjunctive Measures:
  • - Management of polypharmacy and potentially inappropriate medications (PIMs) to improve surgical outcomes in elderly patients. 214

    Special Populations

  • Elderly Patients: Increased risk of polypharmacy and PIMs impacting surgical outcomes; careful medication review recommended. 214
  • Comorbidities: Preoperative disc degeneration and facet joint arthropathy may influence long-term outcomes but do not necessarily preclude surgery. 2161
  • Key Recommendations

  • Preoperative Assessment: Comprehensive evaluation including MRI and functional scoring systems like JOA to guide treatment decisions. (Evidence: Strong 22)
  • Minimally Invasive Decompression: Consider minimally invasive techniques such as endoscopic decompression for decompression, offering comparable outcomes to open surgery. (Evidence: Moderate 160)
  • Manage Polypharmacy: In elderly patients, reduce potentially inappropriate medications before surgery to improve outcomes. (Evidence: Moderate 214)
  • Monitor Adjacent Segment Disease: Postoperative monitoring for adjacent segment degeneration, especially after fusion procedures, is crucial. (Evidence: Moderate 818)
  • Patient Selection for Fusion: Select patients for stabilization procedures based on instability and clinical need, considering long-term outcomes and adjacent segment risks. (Evidence: Moderate 1847)
  • References

    Showing 100 most recent of 316 indexed papers.

    1 Gwak YG, Shin MH. Distal lordotic angle independent of pelvic incidence to reduce the risk of adjacent segment degeneration following L4-S1 posterior lumbar interbody fusion: A retrospective study. Medicine 2026. link 2 Akaike Y, Michikawa T, Tobe T, Tobe R, Kawabata S, Nagai S et al.. Impact of potentially inappropriate medication on surgical outcomes in older patients with lumbar spinal stenosis. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2026. link 3 Acevedo-Gonzalez JC. Intermittent Claudication of the Spinal Cord versus Neurogenic Claudication: Jean Jules Dejerine (1849-1917). World neurosurgery 2026. link 4 Nielsen MS, Konge L, Nielsen AB, Grejs A, Brøchner AC. Should Anaesthesiologists Be Taught to Perform Ultrasound-Assisted Neuraxial Access in Spinal Anaesthesia?-Protocol of a Randomised Controlled Study. Acta anaesthesiologica Scandinavica 2025. link 5 Shellock JL, Zigler JE, Blumenthal SL, Guyer RD, Ohnmeiss DD. Clinical Outcome of Lumbar Hybrid Surgery in a Consecutive Series of Patients With Long-term Follow-up. Spine 2025. link 6 Ding H, Han X, Xing Y, Liu Y, He D, Han X. Clinical and Radiological Comparison of Unilateral Biportal Endoscopic and Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Spinal Degenerative Disease. Orthopaedic surgery 2025. link 7 Li X, Sun Y, Tang G, Chen B, Zhang W. Modified Minimally Invasive Transforaminal Microscope-Assisted Fusion to Treat Lumbar Foraminal Stenosis Combined with Severe Lumbar Degenerative Diseases. World neurosurgery 2025. link 8 Horne F, Louis Atherton M, Motiei-Langroudi R. Adjacent Segment Pathology After Short-Segment Posterior Lumbar Fusion: Postfusion Acceleration of Degeneration or Pre-Existing Degeneration?. Clinical spine surgery 2025. link 9 Han G, Li Q, Shao Q, Li X, Wu H, Yue L et al.. Clinical value of fat depositions in different lumbar areas on spine degeneration and clinical outcomes. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2025. link 10 Cheng X, Chen Q, Chen B, Tang J. Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion with an Expandable Cage for the Treatment of Degenerative Lumbar Spinal Stenosis with Instability. World neurosurgery 2025. link 11 Liu Z, Hao S, Li X, Song E, Yao Y. Clinical efficacy of AUSS/UNSES-TLIF in the treatment of single-segment degenerative lumbar spinal stenosis: a retrospective study. Journal of orthopaedic surgery and research 2025. link 12 Loggia G, Farshad M, Jokeit M, Widmer J, Dossi S, Burkhard MD. Impact of spinal alignment on adjacent segment disease and degeneration after short-segment lumbosacral fusion. The spine journal : official journal of the North American Spine Society 2025. link 13 Kim JE, Park EJ, Park DK. Clinical and Radiologic Outcomes of Single-level Decompression by Unilateral Endoscopic Biportal Technique in Degenerative Spinal Stenosis: Over 5-year Follow-up. Clinical spine surgery 2025. link 14 Kawabata S, Michikawa T, Nagai S, Akaike Y, Imai T, Ito K et al.. Possible negative impact of polypharmacy on surgical outcomes in older patients with lumbar spinal stenosis. Geriatrics & gerontology international 2025. link 15 Wong HCY, Lee SF, Ryu S, Chan AW, Caini S, Johnstone P et al.. Impact of recent clinical trials on meta-analysis of stereotactic body radiation therapy for spine metastases and urgent call for consistent study endpoints. Annals of palliative medicine 2025. link 16 Yang N, Di J, Han X, Zhang W, Cui X, Feng H. Focusing on spinal stenosis: emerging discoveries concerning Alendronate-induced risks and genetic drug targets. Journal of orthopaedic surgery and research 2025. link 17 Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M et al.. ESTRO clinical practice guideline: Stereotactic body radiotherapy for spine metastases. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 2024. link 18 Bakare A, Alvarado AM, Coelho V, Varela JR, Reine GJ, Mazza J et al.. The Impact of L4-L5 Minimally Invasive Transforaminal Lumbar Interbody Fusion on 2-Year Adjacent-level Parameters. World neurosurgery 2024. link 19 Szigethy L, Sigmundsson FG, Joelson A. Surgically Treated Degenerative Lumbar Spine Diseases in Twins. The Journal of bone and joint surgery. American volume 2024. link 20 Guo J, Lv C, Bai T, Li G, Ji X, Zhu K et al.. Comparative study of percutaneous endoscopic lumbar decompression and traditional revision surgery in the treatment of symptomatic adjacent segment degeneration. BMC surgery 2024. link 21 Tarawneh OH, Narayanan R, Trenchfield D, Lee Y, Issa TZ, Dulitzki Y et al.. Impact of Preoperative Intervertebral Disc Degeneration on Patient-Reported Outcome Measures After Lumbar Fusion. World neurosurgery 2024. link 22 Shang Q, Luan H, Peng C, Song X. Comparative effectiveness of cortical bone trajectory screws and pedicle screws in the treatment of adjacent segment degeneration after lumbar fusion surgery: a systematic review and meta-analysis. Journal of orthopaedic surgery and research 2024. link 23 Kwon JW, Park Y, Suk KS, Lee BH, Park SY, Park SR et al.. Proximity Between Screw and Endplate of Upper Instrumented Vertebra Using a Cortical Bone Trajectory Screw can Increase Radiographic Adjacent Segment Degeneration Risks in Patients With Lumbar Spinal Stenosis. Spine 2024. link 24 Han B, Chen Y, Liang W, Yang Y, Ding Z, Yin P et al.. Is the interspinous process device safe and effective in elderly patients with lumbar degeneration? A systematic review and meta-analysis of randomized controlled trials. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2024. link 25 Park S, Hwang CJ, Lee DH, Kim NY, Nam HW, Kang HW et al.. Risk factors of revision operation and early revision for adjacent segment degeneration after lumbar fusion surgery: a case-control study. The spine journal : official journal of the North American Spine Society 2024. link 26 Zhao E, Hirase T, Kim AG, Du JY, Amen TB, Araghi K et al.. The Impact of Posterior Intervertebral Osteophytes on Patient-Reported Outcome Measures After L5-S1 Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion. Spine 2024. link 27 Gazzeri R, Panagiotopoulos K, Leoni MLG, Princiotto SR, De Simone C, Galarza M et al.. Clinical and radiological outcome of stand-alone percutaneous pedicle screw fixation (SAPF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). A propensity-matched cohort study. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2024. link 28 Schönnagel L, Zhu J, Camino-Willhuber G, Guven AE, Tani S, Caffard T et al.. Relationship between lumbar spinal stenosis and axial muscle wasting. The spine journal : official journal of the North American Spine Society 2024. link 29 Li T, Huang J, Zhang H, Lu Z, Liu J, Ding Y. Full endoscopic laminotomy decompression versus anterior cervical discectomy and fusion for the treatment of single-segment cervical spinal stenosis: a retrospective, propensity score-matched study. Journal of orthopaedic surgery and research 2024. link 30 Kerba M, Lourenco RA, Sahgal A, Cardet RF, Siva S, Ding K et al.. An Economic Analysis of SC24 in Canada: A Randomized Study of SBRT Compared With Conventional Palliative RT for Spinal Metastases. International journal of radiation oncology, biology, physics 2024. link 31 Sumitani M, Kimura A, Mochizuki T, Akiyama T, Uranbileg B, Takahashi T et al.. Cerebrospinal Fluid Lysophosphatidylcholine Species for Distinguishing Narrowing of the Lumbar Spine. World neurosurgery 2024. link 32 Kawakami M, Takeshita K, Inoue G, Sekiguchi M, Fujiwara Y, Hoshino M et al.. Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of lumbar spinal stenosis, 2021 - Secondary publication. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2023. link 33 Hou X, Hu H, Kong C, Li Y, Zhang S, Wang W et al.. Correlation of psoas major muscle morphology with function and clinical symptoms in patients with symptomatic multilevel lumbar spinal stenosis. Journal of orthopaedic surgery and research 2023. link 34 Fujii T, Daimon K, Ozaki M, Suzuki S, Takahashi Y, Tsuji O et al.. 10-year Longitudinal MRI Study of Intervertebral Disk Degeneration in Patients With Lumbar Spinal Canal Stenosis After Posterior Lumbar Decompression Surgery. Spine 2023. link 35 Guo Y, Zhou Y, Zhao H, Hu T, Wu D. Serum antioxidant enzymes in spinal stenosis patients with lumbar disc herniation: correlation with degeneration severity and spinal fusion rate. BMC musculoskeletal disorders 2023. link 36 Sudo H, Miyakoshi T, Watanabe Y, Ito YM, Kahata K, Tha KK et al.. Protocol for treating lumbar spinal canal stenosis with a combination of ultrapurified, allogenic bone marrow-derived mesenchymal stem cells and in situ-forming gel: a multicentre, prospective, double-blind randomised controlled trial. BMJ open 2023. link 37 Ding Y, Chen JY, Yang JC, Li RY, Yin YJ, Chen JT et al.. Disc degeneration contributes to the denser bone in the subendplate but not in the vertebral body in patients with lumbar spinal stenosis or disc herniation. The spine journal : official journal of the North American Spine Society 2023. link 38 Minetama M, Kawakami M, Nakatani T, Teraguchi M, Nakagawa M, Yamamoto Y et al.. Lumbar paraspinal muscle morphology is associated with spinal degeneration in patients with lumbar spinal stenosis. The spine journal : official journal of the North American Spine Society 2023. link 39 Lavantes P, Poignard A, Delambre J, Queinnec S, Dufour T, Arvieu R et al.. Influence of the preoperative L5S1 disc state on lateral L2 to L5 fusion's outcomes at an average follow-up of 3,5 years (minimum 2 years). European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2023. link 40 Olmos M, Hernandez NS, Kanter M, Liu P, Riesenburger RI, Kryzanski J. Periprocedural Polypharmacy in Lumbar Fusions Performed Under Spinal Anesthesia Compared With General Anesthesia. Neurosurgery 2023. link 41 Gal R, Charest-Morin R, Verlaan JJ, Fisher CG, Wessels H, Verkooijen HM et al.. Patient Expectations About Palliative Treatment for Symptomatic Spinal Metastases: A Qualitative Study. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research 2023. link 42 Llorián-Salvador Ó, Akhgar J, Pigorsch S, Borm K, Münch S, Bernhardt D et al.. The importance of planning CT-based imaging features for machine learning-based prediction of pain response. Scientific reports 2023. link 43 Huele EH, van der Velden JM, Kasperts N, Eppinga WSC, Grutters JPC, Suelmann BBM et al.. Stereotactic Body radiotherapy and pedicLE screw fixatioN During one hospital visit for patients with symptomatic unstable spinal metastases: a randomized trial (BLEND RCT) using the Trials within Cohorts (TwiCs) design. Trials 2023. link 44 Wong HCY, Lee SF, Chan AW, Caini S, Hoskin P, Simone CB et al.. Stereotactic body radiation therapy versus conventional external beam radiotherapy for spinal metastases: A systematic review and meta-analysis of randomized controlled trials. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 2023. link 45 Kang SY, Cho HS, Yi J, Kim HS, Jang IT, Kim DH. The Comparison of Fluoroscopy-Guided Epidural Anesthesia with Conscious Sedation and General Anesthesia for Endoscopic Lumbar Decompression Surgery: A Retrospective Analysis. World neurosurgery 2022. link 46 Arzoglou V, Vial I, Hussain M, Deepak S, Andalib A, Storey M et al.. Lumbar Fixation Using the Cortical Bone Trajectory Fixation: A Single Surgeon's Experience With 3-Year Follow-up. Operative neurosurgery (Hagerstown, Md.) 2022. link 47 Jeong TS, Son S, Lee SG, Ahn Y, Jung JM, Yoo BR. Comparison of adjacent segment disease after minimally invasive versus open lumbar fusion: a minimum 10-year follow-up. Journal of neurosurgery. Spine 2022. link 48 Minetama M, Kawakami M, Teraguchi M, Matsuo S, Sumiya T, Nakagawa M et al.. Endplate defects, not the severity of spinal stenosis, contribute to low back pain in patients with lumbar spinal stenosis. The spine journal : official journal of the North American Spine Society 2022. link 49 Roh YH, Lee JC, Hwang J, Cho HK, Soh J, Choi SW et al.. Long-Term Clinical and Radiological Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion: 10-Year Follow-up Results. Journal of Korean medical science 2022. link 50 Nakajima H, Honjoh K, Watanabe S, Kubota A, Matsumine A. Relationship Between Vertebral Bone Marrow Edema and Early Progression of Intervertebral Disc Wedge or Narrowing After Lumbar Decompression Surgery. Spine 2022. link 51 Minetama M, Kawakami M, Teraguchi M, Matsuo S, Enyo Y, Nakagawa M et al.. MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis. BMC musculoskeletal disorders 2022. link 52 Aaen J, Banitalebi H, Austevoll IM, Hellum C, Storheim K, Myklebust TÅ et al.. The association between preoperative MRI findings and clinical improvement in patients included in the NORDSTEN spinal stenosis trial. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2022. link 53 Dunne EM, Liu MC, Lo SS, Sahgal A. The Changing Landscape for the Treatment of Painful Spinal Metastases: is Stereotactic Body Radiation Therapy the New Standard of Care?. Clinical oncology (Royal College of Radiologists (Great Britain)) 2022. link 54 Singh R, Valluri A, Jenkins J, Davis J, Vargo JA, Sharma S. Stereotactic Body Radiation Therapy (SBRT) for Spinal Metastases: Real-world Outcomes From an International Multi-institutional SBRT Registry. American journal of clinical oncology 2022. link 55 Cazzato RL, Jennings JW, Autrusseau PA, De Marini P, Auloge P, Tomasian A et al.. Percutaneous image-guided cryoablation of spinal metastases: over 10-year experience in two academic centers. European radiology 2022. link 56 Wang HH, Tian SS, Yang JM, Sun BS, Chen Y, Song YC et al.. Risk-adapted stereotactic body radiotherapy for patients with cervical spinal metastases. Cancer science 2022. link 57 Gal R, van der Velden JM, Bach DC, Verlaan JJ, Geuze RE, Rutges JP et al.. Translation and validation of the Dutch Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0) to evaluate health-related quality of life in patients with symptomatic spinal metastases. BMC musculoskeletal disorders 2022. link 58 Amelot A. Regarding "Surgical Metastasectomy in the Spine: A Review Article". The oncologist 2021. link 59 Bydon M, Michalopoulos GD, Alvi MA, Goyal A, Abode-Iyamah K. Cervical Total Disc Replacement: Food and Drug Administration-Approved Devices. Neurosurgery clinics of North America 2021. link 60 Shepard NA, Protopsaltis T, Kim Y. Lumbar Endoscopic Spine Surgery A Comprehensive Review. Bulletin of the Hospital for Joint Disease (2013) 2021. link 61 Chou PH, Lin HH, Yao YC, Wang ST, Chang MC, Liu CL. Preoperative facet joint arthropathy does not impact long-term clinical outcomes after lumbar-stability-preserving decompression and dynesys fixation. Scientific reports 2021. link 62 Safaee MM, Chang D, Hillman JM, Shah SS, Garcia J, Wadhwa H et al.. Implementation of Outpatient Minimally Invasive Lumbar Decompression at an Academic Medical Center without Ambulatory Surgery Centers: A Cost Analysis and Systematic Review. World neurosurgery 2021. link 63 Hiyama A, Katoh H, Sakai D, Sato M, Watanabe M. Radiographic and clinical evaluation of single-level lateral interbody fusion in patients with severe stenosis analyzed using cluster analysis. Medicine 2021. link 64 Kaye AD, Edinoff AN, Temple SN, Kaye AJ, Chami AA, Shah RJ et al.. A Comprehensive Review of Novel Interventional Techniques for Chronic Pain: Spinal Stenosis and Degenerative Disc Disease-MILD Percutaneous Image Guided Lumbar Decompression, Vertiflex Interspinous Spacer, MinuteMan G3 Interspinous-Interlaminar Fusion. Advances in therapy 2021. link 65 Aihara T, Endo K, Suzuki H, Kojima A, Sawaji Y, Urushibara M et al.. Long-Term Outcomes Following Lumbar Microendoscopic Decompression for Lumbar Spinal Stenosis with and without Degenerative Spondylolisthesis: Minimum 10-Year Follow-Up. World neurosurgery 2021. link 66 Yoshikane K, Kikuchi K, Okazaki K. Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression for Lumbar Spinal Stenosis Provides Comparable Clinical Outcomes in Patients with and without Degenerative Spondylolisthesis. World neurosurgery 2021. link 67 Hiyama A, Katoh H, Sakai D, Sato M, Tanaka M, Watanabe M. Cluster analysis to predict factors associated with sufficient indirect decompression immediately after single-level lateral lumbar interbody fusion. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2021. link 68 Pojskic M, Saβ B, Völlger B, Nimsky C, Carl B. Extreme lateral interbody fusion (XLIF) in a consecutive series of 72 patients. Bosnian journal of basic medical sciences 2021. link 69 Halalmeh DR, Perez-Cruet MJ. Use of Local Morselized Bone Autograft in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Cost Analysis. World neurosurgery 2021. link 70 Zhou C, Cha T, Wang W, Guo R, Li G. Investigation of Alterations in the Lumbar Disc Biomechanics at the Adjacent Segments After Spinal Fusion Using a Combined In Vivo and In Silico Approach. Annals of biomedical engineering 2021. link 71 Yu X, Zhao J, Feng F, Han Y, Zhong G, Liu Z et al.. Inclination of the small laminar slope angle leads to lumbar spinal stenosis due to hypertrophy of the ligamentum flavum. Journal of orthopaedic surgery (Hong Kong) 2021. link 72 Wu B, Tian X, Shi C, Jiang C, Zhang J, Zhan G et al.. Clinical Outcomes of "U" Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation. Pain research & management 2021. link 73 Shawky Abdelgawaad A, Ezzati A, Krajnovic B, Seyed-Emadaldin S, Abdelrahman H. Radiofrequency ablation and balloon kyphoplasty for palliation of painful spinal metastases. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2021. link 74 Wakabayashi K, Koide Y, Aoyama T, Shimizu H, Miyauchi R, Tanaka H et al.. A predictive model for pain response following radiotherapy for treatment of spinal metastases. Scientific reports 2021. link 75 Pontoriero A, Lillo S, Caravatta L, Bellafiore F, Longo S, Lattanzi E et al.. Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation : Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] 2021. link 76 Abbas J, Peled N, Hershkovitz I, Hamoud K. Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis. BioMed research international 2020. link 77 Aihara T, Endo K, Sawaji Y, Suzuki H, Urushibara M, Kojima A et al.. Five-year Reoperation Rates and Causes for Reoperations Following Lumbar Microendoscopic Discectomy and Decompression. Spine 2020. link 78 Siller S, Pannenbaecker L, Tonn JC, Zausinger S. Surgery of degenerative thoracic spinal stenosis-long-term outcome with quality-of-life after posterior decompression via an uni- or bilateral approach. Acta neurochirurgica 2020. link 79 Jiang H, Moro A, Liu Y, Wang J, Meng D, Zhan X et al.. Two GWAS-identified variants are associated with lumbar spinal stenosis and Gasdermin-C expression in Chinese population. Scientific reports 2020. link 80 Natalia F, Meidia H, Afriliana N, Young JC, Yunus RE, Al-Jumaily M et al.. Automated measurement of anteroposterior diameter and foraminal widths in MRI images for lumbar spinal stenosis diagnosis. PloS one 2020. link 81 Austevoll IM, Gjestad R, Solberg T, Storheim K, Brox JI, Hermansen E et al.. Comparative Effectiveness of Microdecompression Alone vs Decompression Plus Instrumented Fusion in Lumbar Degenerative Spondylolisthesis. JAMA network open 2020. link 82 Xie Y, Zhou Q, Wang X, Jian Q, Fan X, Yu Y et al.. The biomechanical effects of foraminoplasty of different areas under lumbar percutaneous endoscopy on intervertebral discs: A 3D finite element analysis. Medicine 2020. link 83 Kim SI, Min HK, Ha KY, Park HY, Cho CH, Cho RK et al.. Effects of Restoration of Sagittal Alignment on Adjacent Segment Degeneration in Instrumented Lumbar Fusions. Spine 2020. link 84 Fu C, Chen T, Yang Y, Yang H, Diao M, Zhang G et al.. Clinical efficacy and radiographic K-rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis. BMC musculoskeletal disorders 2020. link 85 Oestergaard LG, Christensen FB, Bünger CE, Søgaard R, Holm R, Helmig P et al.. Does adding case management to standard rehabilitation affect functional ability, pain, or the rate of return to work after lumbar spinal fusion? A randomized controlled trial with two-year follow-up. Clinical rehabilitation 2020. link 86 Yokoyama K, Yamada M, Tanaka H, Ito Y, Sugie A, Wanibuchi M et al.. Factors of Adjacent Segment Disease Onset After Microsurgical Decompression for Lumbar Spinal Canal Stenosis. World neurosurgery 2020. link 87 Oestergaard LG, Christensen FB, Nielsen CV, Bünger CE, Holm R, Helmig P et al.. Case manager-assisted rehabilitation for lumbar spinal fusion patients: an economic evaluation alongside a randomized controlled trial with two-year follow-up. Clinical rehabilitation 2020. link 88 Cheng XK, Cheng YP, Liu ZY, Bian FC, Yang FK, Yang N et al.. Percutaneous transforaminal endoscopic decompression for lumbar spinal stenosis with degenerative spondylolisthesis in the elderly. Clinical neurology and neurosurgery 2020. link 89 Ruetten S, Komp M. Endoscopic Lumbar Decompression. Neurosurgery clinics of North America 2020. link 90 Shamov T, Al-Hashel JY, Rоusseff RT. Fluoroscopic Epidural Steroid Injection: Pain Relief in Discogenic Sciatica Versus Lumbar Spinal Stenosis. A Study on Middle Eastern Patients. Acta medica (Hradec Kralove) 2020. link 91 Yoo JS, Patel DS, Hrynewycz NM, Brundage TS, Mogilevsky FA, Singh K. The Effect of Preoperative Symptom Duration on Postoperative Outcomes After Minimally Invasive Transforaminal Lumbar Interbody Fusion. Clinical spine surgery 2020. link 92 Kovari VZ, Kuti A, Konya K, Szel I, Szekely AK, Szalay K. Comparison of Single-Level Open and Minimally Invasive Transforaminal Lumbar Interbody Fusions Presenting a Learning Curve. BioMed research international 2020. link 93 Lee JH, Kim SK, Kang SS, Han SJ, Lee CK, Chang BS. A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion. Clinical spine surgery 2020. link 94 Gal R, Oostinga D, Wessels H, Verlaan JJ, Charest-Morin R, Fisher CG et al.. Pre-treatment expectations of patients with spinal metastases: what do we know and what can we learn from other disciplines? A systematic review of qualitative studies. BMC cancer 2020. link 95 Meena RK, Doddamani RS, Chipde H, Mahajan S, Chandra SP, Sawarkar DP. Primary spinal atypical teratoid/rhabdoid tumour presenting with hematomyelia and subarachnoid haemorrhage-a case report. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 2020. link 96 Babu JM, Patel SA, Palumbo MA, Daniels AH. Spinal Emergencies in Primary Care Practice. The American journal of medicine 2019. link 97 Shen J. Fully Endoscopic Lumbar Laminectomy and Transforaminal Lumbar Interbody Fusion Under Local Anesthesia with Conscious Sedation: A Case Series. World neurosurgery 2019. link 98 Ilyas H, Udo-Inyang I, Savage J. Lumbar Spinal Stenosis and Degenerative Spondylolisthesis: A Review of the SPORT Literature. Clinical spine surgery 2019. link 99 Zini C, Bellini M, Masala S, Marcia S. Percutaneous Interspinous Spacer in Spinal-Canal-Stenosis Treatment: Pros and Cons. Medicina (Kaunas, Lithuania) 2019. link 100 Chachan S, Bae J, Lee SH, Suk JW, Shin SH. Microscopic Anterior Neural Decompression Combined with Oblique Lumbar Interbody Fusion-A Technical Note. World neurosurgery 2019. link

    Original source

    1. [1]
    2. [2]
      Impact of potentially inappropriate medication on surgical outcomes in older patients with lumbar spinal stenosis.Akaike Y, Michikawa T, Tobe T, Tobe R, Kawabata S, Nagai S et al. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association (2026)
    3. [3]
    4. [4]
      Should Anaesthesiologists Be Taught to Perform Ultrasound-Assisted Neuraxial Access in Spinal Anaesthesia?-Protocol of a Randomised Controlled Study.Nielsen MS, Konge L, Nielsen AB, Grejs A, Brøchner AC Acta anaesthesiologica Scandinavica (2025)
    5. [5]
      Clinical Outcome of Lumbar Hybrid Surgery in a Consecutive Series of Patients With Long-term Follow-up.Shellock JL, Zigler JE, Blumenthal SL, Guyer RD, Ohnmeiss DD Spine (2025)
    6. [6]
    7. [7]
    8. [8]
    9. [9]
      Clinical value of fat depositions in different lumbar areas on spine degeneration and clinical outcomes.Han G, Li Q, Shao Q, Li X, Wu H, Yue L et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2025)
    10. [10]
    11. [11]
      Clinical efficacy of AUSS/UNSES-TLIF in the treatment of single-segment degenerative lumbar spinal stenosis: a retrospective study.Liu Z, Hao S, Li X, Song E, Yao Y Journal of orthopaedic surgery and research (2025)
    12. [12]
      Impact of spinal alignment on adjacent segment disease and degeneration after short-segment lumbosacral fusion.Loggia G, Farshad M, Jokeit M, Widmer J, Dossi S, Burkhard MD The spine journal : official journal of the North American Spine Society (2025)
    13. [13]
    14. [14]
      Possible negative impact of polypharmacy on surgical outcomes in older patients with lumbar spinal stenosis.Kawabata S, Michikawa T, Nagai S, Akaike Y, Imai T, Ito K et al. Geriatrics & gerontology international (2025)
    15. [15]
    16. [16]
      Focusing on spinal stenosis: emerging discoveries concerning Alendronate-induced risks and genetic drug targets.Yang N, Di J, Han X, Zhang W, Cui X, Feng H Journal of orthopaedic surgery and research (2025)
    17. [17]
      ESTRO clinical practice guideline: Stereotactic body radiotherapy for spine metastases.Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M et al. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (2024)
    18. [18]
      The Impact of L4-L5 Minimally Invasive Transforaminal Lumbar Interbody Fusion on 2-Year Adjacent-level Parameters.Bakare A, Alvarado AM, Coelho V, Varela JR, Reine GJ, Mazza J et al. World neurosurgery (2024)
    19. [19]
      Surgically Treated Degenerative Lumbar Spine Diseases in Twins.Szigethy L, Sigmundsson FG, Joelson A The Journal of bone and joint surgery. American volume (2024)
    20. [20]
    21. [21]
      Impact of Preoperative Intervertebral Disc Degeneration on Patient-Reported Outcome Measures After Lumbar Fusion.Tarawneh OH, Narayanan R, Trenchfield D, Lee Y, Issa TZ, Dulitzki Y et al. World neurosurgery (2024)
    22. [22]
    23. [23]
    24. [24]
      Is the interspinous process device safe and effective in elderly patients with lumbar degeneration? A systematic review and meta-analysis of randomized controlled trials.Han B, Chen Y, Liang W, Yang Y, Ding Z, Yin P et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2024)
    25. [25]
      Risk factors of revision operation and early revision for adjacent segment degeneration after lumbar fusion surgery: a case-control study.Park S, Hwang CJ, Lee DH, Kim NY, Nam HW, Kang HW et al. The spine journal : official journal of the North American Spine Society (2024)
    26. [26]
    27. [27]
      Clinical and radiological outcome of stand-alone percutaneous pedicle screw fixation (SAPF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). A propensity-matched cohort study.Gazzeri R, Panagiotopoulos K, Leoni MLG, Princiotto SR, De Simone C, Galarza M et al. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2024)
    28. [28]
      Relationship between lumbar spinal stenosis and axial muscle wasting.Schönnagel L, Zhu J, Camino-Willhuber G, Guven AE, Tani S, Caffard T et al. The spine journal : official journal of the North American Spine Society (2024)
    29. [29]
    30. [30]
      An Economic Analysis of SC24 in Canada: A Randomized Study of SBRT Compared With Conventional Palliative RT for Spinal Metastases.Kerba M, Lourenco RA, Sahgal A, Cardet RF, Siva S, Ding K et al. International journal of radiation oncology, biology, physics (2024)
    31. [31]
      Cerebrospinal Fluid Lysophosphatidylcholine Species for Distinguishing Narrowing of the Lumbar Spine.Sumitani M, Kimura A, Mochizuki T, Akiyama T, Uranbileg B, Takahashi T et al. World neurosurgery (2024)
    32. [32]
      Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of lumbar spinal stenosis, 2021 - Secondary publication.Kawakami M, Takeshita K, Inoue G, Sekiguchi M, Fujiwara Y, Hoshino M et al. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association (2023)
    33. [33]
      Correlation of psoas major muscle morphology with function and clinical symptoms in patients with symptomatic multilevel lumbar spinal stenosis.Hou X, Hu H, Kong C, Li Y, Zhang S, Wang W et al. Journal of orthopaedic surgery and research (2023)
    34. [34]
    35. [35]
    36. [36]
    37. [37]
      Disc degeneration contributes to the denser bone in the subendplate but not in the vertebral body in patients with lumbar spinal stenosis or disc herniation.Ding Y, Chen JY, Yang JC, Li RY, Yin YJ, Chen JT et al. The spine journal : official journal of the North American Spine Society (2023)
    38. [38]
      Lumbar paraspinal muscle morphology is associated with spinal degeneration in patients with lumbar spinal stenosis.Minetama M, Kawakami M, Nakatani T, Teraguchi M, Nakagawa M, Yamamoto Y et al. The spine journal : official journal of the North American Spine Society (2023)
    39. [39]
      Influence of the preoperative L5S1 disc state on lateral L2 to L5 fusion's outcomes at an average follow-up of 3,5 years (minimum 2 years).Lavantes P, Poignard A, Delambre J, Queinnec S, Dufour T, Arvieu R et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2023)
    40. [40]
      Periprocedural Polypharmacy in Lumbar Fusions Performed Under Spinal Anesthesia Compared With General Anesthesia.Olmos M, Hernandez NS, Kanter M, Liu P, Riesenburger RI, Kryzanski J Neurosurgery (2023)
    41. [41]
      Patient Expectations About Palliative Treatment for Symptomatic Spinal Metastases: A Qualitative Study.Gal R, Charest-Morin R, Verlaan JJ, Fisher CG, Wessels H, Verkooijen HM et al. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (2023)
    42. [42]
      The importance of planning CT-based imaging features for machine learning-based prediction of pain response.Llorián-Salvador Ó, Akhgar J, Pigorsch S, Borm K, Münch S, Bernhardt D et al. Scientific reports (2023)
    43. [43]
    44. [44]
      Stereotactic body radiation therapy versus conventional external beam radiotherapy for spinal metastases: A systematic review and meta-analysis of randomized controlled trials.Wong HCY, Lee SF, Chan AW, Caini S, Hoskin P, Simone CB et al. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (2023)
    45. [45]
    46. [46]
      Lumbar Fixation Using the Cortical Bone Trajectory Fixation: A Single Surgeon's Experience With 3-Year Follow-up.Arzoglou V, Vial I, Hussain M, Deepak S, Andalib A, Storey M et al. Operative neurosurgery (Hagerstown, Md.) (2022)
    47. [47]
      Comparison of adjacent segment disease after minimally invasive versus open lumbar fusion: a minimum 10-year follow-up.Jeong TS, Son S, Lee SG, Ahn Y, Jung JM, Yoo BR Journal of neurosurgery. Spine (2022)
    48. [48]
      Endplate defects, not the severity of spinal stenosis, contribute to low back pain in patients with lumbar spinal stenosis.Minetama M, Kawakami M, Teraguchi M, Matsuo S, Sumiya T, Nakagawa M et al. The spine journal : official journal of the North American Spine Society (2022)
    49. [49]
      Long-Term Clinical and Radiological Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion: 10-Year Follow-up Results.Roh YH, Lee JC, Hwang J, Cho HK, Soh J, Choi SW et al. Journal of Korean medical science (2022)
    50. [50]
    51. [51]
      MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis.Minetama M, Kawakami M, Teraguchi M, Matsuo S, Enyo Y, Nakagawa M et al. BMC musculoskeletal disorders (2022)
    52. [52]
      The association between preoperative MRI findings and clinical improvement in patients included in the NORDSTEN spinal stenosis trial.Aaen J, Banitalebi H, Austevoll IM, Hellum C, Storheim K, Myklebust TÅ et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2022)
    53. [53]
      The Changing Landscape for the Treatment of Painful Spinal Metastases: is Stereotactic Body Radiation Therapy the New Standard of Care?Dunne EM, Liu MC, Lo SS, Sahgal A Clinical oncology (Royal College of Radiologists (Great Britain)) (2022)
    54. [54]
      Stereotactic Body Radiation Therapy (SBRT) for Spinal Metastases: Real-world Outcomes From an International Multi-institutional SBRT Registry.Singh R, Valluri A, Jenkins J, Davis J, Vargo JA, Sharma S American journal of clinical oncology (2022)
    55. [55]
      Percutaneous image-guided cryoablation of spinal metastases: over 10-year experience in two academic centers.Cazzato RL, Jennings JW, Autrusseau PA, De Marini P, Auloge P, Tomasian A et al. European radiology (2022)
    56. [56]
      Risk-adapted stereotactic body radiotherapy for patients with cervical spinal metastases.Wang HH, Tian SS, Yang JM, Sun BS, Chen Y, Song YC et al. Cancer science (2022)
    57. [57]
    58. [58]
    59. [59]
      Cervical Total Disc Replacement: Food and Drug Administration-Approved Devices.Bydon M, Michalopoulos GD, Alvi MA, Goyal A, Abode-Iyamah K Neurosurgery clinics of North America (2021)
    60. [60]
      Lumbar Endoscopic Spine Surgery A Comprehensive Review.Shepard NA, Protopsaltis T, Kim Y Bulletin of the Hospital for Joint Disease (2013) (2021)
    61. [61]
    62. [62]
    63. [63]
    64. [64]
    65. [65]
    66. [66]
    67. [67]
      Cluster analysis to predict factors associated with sufficient indirect decompression immediately after single-level lateral lumbar interbody fusion.Hiyama A, Katoh H, Sakai D, Sato M, Tanaka M, Watanabe M Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2021)
    68. [68]
      Extreme lateral interbody fusion (XLIF) in a consecutive series of 72 patients.Pojskic M, Saβ B, Völlger B, Nimsky C, Carl B Bosnian journal of basic medical sciences (2021)
    69. [69]
    70. [70]
    71. [71]
      Inclination of the small laminar slope angle leads to lumbar spinal stenosis due to hypertrophy of the ligamentum flavum.Yu X, Zhao J, Feng F, Han Y, Zhong G, Liu Z et al. Journal of orthopaedic surgery (Hong Kong) (2021)
    72. [72]
    73. [73]
      Radiofrequency ablation and balloon kyphoplasty for palliation of painful spinal metastases.Shawky Abdelgawaad A, Ezzati A, Krajnovic B, Seyed-Emadaldin S, Abdelrahman H European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2021)
    74. [74]
      A predictive model for pain response following radiotherapy for treatment of spinal metastases.Wakabayashi K, Koide Y, Aoyama T, Shimizu H, Miyauchi R, Tanaka H et al. Scientific reports (2021)
    75. [75]
      Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation : Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).Pontoriero A, Lillo S, Caravatta L, Bellafiore F, Longo S, Lattanzi E et al. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (2021)
    76. [76]
      Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis.Abbas J, Peled N, Hershkovitz I, Hamoud K BioMed research international (2020)
    77. [77]
      Five-year Reoperation Rates and Causes for Reoperations Following Lumbar Microendoscopic Discectomy and Decompression.Aihara T, Endo K, Sawaji Y, Suzuki H, Urushibara M, Kojima A et al. Spine (2020)
    78. [78]
    79. [79]
      Two GWAS-identified variants are associated with lumbar spinal stenosis and Gasdermin-C expression in Chinese population.Jiang H, Moro A, Liu Y, Wang J, Meng D, Zhan X et al. Scientific reports (2020)
    80. [80]
      Automated measurement of anteroposterior diameter and foraminal widths in MRI images for lumbar spinal stenosis diagnosis.Natalia F, Meidia H, Afriliana N, Young JC, Yunus RE, Al-Jumaily M et al. PloS one (2020)
    81. [81]
      Comparative Effectiveness of Microdecompression Alone vs Decompression Plus Instrumented Fusion in Lumbar Degenerative Spondylolisthesis.Austevoll IM, Gjestad R, Solberg T, Storheim K, Brox JI, Hermansen E et al. JAMA network open (2020)
    82. [82]
    83. [83]
    84. [84]
      Clinical efficacy and radiographic K-rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis.Fu C, Chen T, Yang Y, Yang H, Diao M, Zhang G et al. BMC musculoskeletal disorders (2020)
    85. [85]
    86. [86]
      Factors of Adjacent Segment Disease Onset After Microsurgical Decompression for Lumbar Spinal Canal Stenosis.Yokoyama K, Yamada M, Tanaka H, Ito Y, Sugie A, Wanibuchi M et al. World neurosurgery (2020)
    87. [87]
      Case manager-assisted rehabilitation for lumbar spinal fusion patients: an economic evaluation alongside a randomized controlled trial with two-year follow-up.Oestergaard LG, Christensen FB, Nielsen CV, Bünger CE, Holm R, Helmig P et al. Clinical rehabilitation (2020)
    88. [88]
      Percutaneous transforaminal endoscopic decompression for lumbar spinal stenosis with degenerative spondylolisthesis in the elderly.Cheng XK, Cheng YP, Liu ZY, Bian FC, Yang FK, Yang N et al. Clinical neurology and neurosurgery (2020)
    89. [89]
      Endoscopic Lumbar Decompression.Ruetten S, Komp M Neurosurgery clinics of North America (2020)
    90. [90]
    91. [91]
      The Effect of Preoperative Symptom Duration on Postoperative Outcomes After Minimally Invasive Transforaminal Lumbar Interbody Fusion.Yoo JS, Patel DS, Hrynewycz NM, Brundage TS, Mogilevsky FA, Singh K Clinical spine surgery (2020)
    92. [92]
      Comparison of Single-Level Open and Minimally Invasive Transforaminal Lumbar Interbody Fusions Presenting a Learning Curve.Kovari VZ, Kuti A, Konya K, Szel I, Szekely AK, Szalay K BioMed research international (2020)
    93. [93]
    94. [94]
    95. [95]
      Primary spinal atypical teratoid/rhabdoid tumour presenting with hematomyelia and subarachnoid haemorrhage-a case report.Meena RK, Doddamani RS, Chipde H, Mahajan S, Chandra SP, Sawarkar DP Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (2020)
    96. [96]
      Spinal Emergencies in Primary Care Practice.Babu JM, Patel SA, Palumbo MA, Daniels AH The American journal of medicine (2019)
    97. [97]
    98. [98]
      Lumbar Spinal Stenosis and Degenerative Spondylolisthesis: A Review of the SPORT Literature.Ilyas H, Udo-Inyang I, Savage J Clinical spine surgery (2019)
    99. [99]
      Percutaneous Interspinous Spacer in Spinal-Canal-Stenosis Treatment: Pros and Cons.Zini C, Bellini M, Masala S, Marcia S Medicina (Kaunas, Lithuania) (2019)
    100. [100]
      Microscopic Anterior Neural Decompression Combined with Oblique Lumbar Interbody Fusion-A Technical Note.Chachan S, Bae J, Lee SH, Suk JW, Shin SH World neurosurgery (2019)

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