Lumbar canal stenosis is an increasingly recognized condition in patients more than 65 years of age. The clinical syndrome is dominated by neurogenic claudication. The natural history of the Condition is not yet well described. Long-term results of surgical therapy are frequently disappointing, and reoperation is required in more than 10% of patients. Nonoperative treatment options include physical therapy exercise programs, calcitonin, analgesics, and epidural steroid injections. A clinical pathway for management of symptomatic stenosis, emphasizing an initial nonoperative approach, is suggested.
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