{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:58:32Z","timestamp":1790179112622,"version":"4.1.0"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Lumbar spinal stenosis (LSS) can lead to compression of the neural and vascular elements and is becoming more common due to degenerative changes that occur because of aging processes. Symptoms may manifest as pain and discomfort that radiates to the lower leg, thigh, and\/or buttocks. The traditional treatment algorithm for LSS consists of conservative management (physical therapy, medication, education, exercise), often followed by epidural steroid injections (ESIs), and when nonsurgical treatment has failed, open decompression surgery with or without fusion is considered. In this review, the variables that should be considered during the management of patients with LSS are discussed, and the role of each treatment option to provide optimal care is evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review leads to the creation of an evidence-based practical algorithm to aid clinicians in the management of patients with LSS. Special emphasis is directed at minimally invasive surgery, which should be taken into consideration when conservative management and ESI have failed.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pm\/pnz133","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T19:12:03Z","timestamp":1564600323000},"page":"S23-S31","source":"Crossref","is-referenced-by-count":46,"title":["An Algorithmic Approach to Treating Lumbar Spinal Stenosis: An Evidenced-Based Approach"],"prefix":"10.1093","volume":"20","author":[{"given":"Sudhir","family":"Diwan","sequence":"first","affiliation":[{"name":"Advanced Spine on Park Avenue, New York, NY 10022"},{"name":"Albert Einstein College of Medicine, Pain Attending, Lenox Hill Hospital, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawood","family":"Sayed","sequence":"first","affiliation":[{"name":"University of Kansas Medical Center, Kansas City, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R","family":"Deer","sequence":"first","affiliation":[{"name":"The Center for Pain Relief, Spine and Nerve Centers of the Virginias, Charleston, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Salomons","sequence":"first","affiliation":[{"name":"Factory CRO, Bilthoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0605-0546","authenticated-orcid":false,"given":"Kevin","family":"Liang","sequence":"first","affiliation":[{"name":"Milestone Research Organization, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"issue":"7","key":"2020032715345787700_pnz133-B1","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.spinee.2012.11.059","article-title":"An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update)","volume":"13","author":"Kreiner","year":"2013","journal-title":"Spine J"},{"issue":"8","key":"2020032715345787700_pnz133-B2","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1056\/NEJMcp0708097","article-title":"Clinical practice. 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