Efficacy of conservative treatment of lumbar spinal stenosis

Symptomatic spinal stenosis due to lumbar degenerative disease is usually characterized by a gradual onset of low back and lower extremity discomfort. The disease usually is slowly progressive and is managed conservatively in the vast majority of cases. In rare circumstances, a patient may present with symptoms consistent with cauda equina syndrome because of a superimposed disc herniation in the setting of a narrowed lumbar canal. In such situations, we recommend urgent decompression to optimize neurological return.