{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T20:50:35Z","timestamp":1773867035475,"version":"3.50.1"},"reference-count":91,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,4,12]],"date-time":"2014-04-12T00:00:00Z","timestamp":1397260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lumbar spinal stenosis (LSS) functionally impacts significant numbers of Americans per year. Current estimates place the number of Americans suffering from senescent lumbar spinal stenosis at 400,000. The prevalence of this disorder in patients ranging from 60 to 69\u00a0years of age is very high. Forty\u2010seven percent of this age group have mild to moderate stenosis, and 19.7% have severe stenosis. As the baby boomer generation gets older, 10,000 individuals attain the age of 65\u00a0years every day in United States. LSS is becoming very common and will be a major healthcare issue as the population ages. Although LSS is not life threatening, it can cause substantial disability with limitations to performing daily activities, and thus, the associated negative impact on quality of life (QOL). This article reviews the pathophysiology and current treatment options for LSS, focusing on evidence\u2010based treatment options.<\/jats:p>","DOI":"10.1111\/papr.12188","type":"journal-article","created":{"date-parts":[[2014,4,12]],"date-time":"2014-04-12T06:38:46Z","timestamp":1397284726000},"page":"68-81","source":"Crossref","is-referenced-by-count":46,"title":["Lumbar Spinal Stenosis: Therapeutic Options Review"],"prefix":"10.1111","volume":"15","author":[{"given":"Shrif","family":"Costandi","sequence":"first","affiliation":[{"name":"Department of Pain Management Cleveland Clinic Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bohdan","family":"Chopko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stanford University Henderson Nevada U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mena","family":"Mekhail","sequence":"additional","affiliation":[{"name":"LECOM Bradenton Florida U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Dews","sequence":"additional","affiliation":[{"name":"Department of Pain Management Cleveland Clinic Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagy","family":"Mekhail","sequence":"additional","affiliation":[{"name":"Department of Pain Management Cleveland Clinic Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2009.03.005"},{"key":"e_1_2_13_3_1","first-page":"1530","article-title":"Long\u2010term results of percutaneous Lumbar decompression","volume":"11","author":"Mekhail N","year":"2011","journal-title":"Pain Pract."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.36B2.230"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100070116"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199611010-00002"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-197901000-00014"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198706000-00013"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000188117.77657.ee"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002560050596"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1093\/neurosurgery\/20.CN_suppl_1.204","article-title":"Neurogenic intermittent claudication in cases with absolute and relative stenosis of the lumbar vertebral canal (ASLC and RSLC), in cases of narrow lumbar intervertebral foramina, and in cases with both entities","volume":"20","author":"Verbiest J","year":"1973","journal-title":"Clin Neurosurg."},{"key":"e_1_2_13_12_1","first-page":"1385","article-title":"Pressure changes following constriction of the cauda equina: an experimental study in situ","volume":"12","author":"Schonstrom NSR","year":"1988","journal-title":"Spine."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112010-00015"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199712150-00021"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199505150-00013"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.4065\/76.11.1120"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2007.12.007"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2007.01.003"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200006010-00016"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/02688699647087"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31820c97b1"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2009.12.003"},{"key":"e_1_2_13_23_1","unstructured":"North American Spine Society (NASS)(Evidence\u2010Based Clinical Guidelines for Multidisciplinary Spine Care).Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis.2011."},{"key":"e_1_2_13_24_1","first-page":"75","article-title":"Conservative treatment of lumbar spinal stenosis\u2010a review","volume":"146","author":"Theodoridis T","year":"2008","journal-title":"Z Orthop Unfall."},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2007.01.004"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.05.028"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200103000-00017"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215510367539"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000241136.98159.8c"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0004-9514(07)70040-5"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31819c0a6b"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000261029.29170.e6"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318240d57d"},{"key":"e_1_2_13_34_1","doi-asserted-by":"crossref","first-page":"S181","DOI":"10.36076\/ppj.2008\/11\/S181","article-title":"Effectiveness of opioids in the treatment of chronic cancer pain","volume":"11","author":"Trescot AM","year":"2008","journal-title":"Pain Physician."},{"key":"e_1_2_13_35_1","first-page":"S5","article-title":"Opioids in the management of chronic non\u2010cancer pain. An Update of the American Society of Interventional pain physicians (ASIPP) guidelines","volume":"11","author":"Trescot AM","year":"2008","journal-title":"Pain Physician."},{"key":"e_1_2_13_36_1","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.36076\/ppj.2008\/11\/S133","article-title":"Opioids pharmacology","volume":"11","author":"Trescot AM","year":"2008","journal-title":"Pain Physician."},{"key":"e_1_2_13_37_1","doi-asserted-by":"crossref","first-page":"S155","DOI":"10.36076\/ppj.2008\/11\/S155","article-title":"Monitoring opioids adherence in chronic pain patients: tools, techniques and utility","volume":"11","author":"Manchikanti L","year":"2008","journal-title":"Pain Physician."},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31818f924d"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198309000-00004"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00296769"},{"key":"e_1_2_13_41_1","first-page":"825","article-title":"Methylcobalamin as an adjuvant medication in conservative treatment of lumbar spinal stenosis","volume":"83","author":"Waikakul W","year":"2000","journal-title":"J Med Assoc Thai."},{"key":"e_1_2_13_42_1","doi-asserted-by":"crossref","first-page":"833","DOI":"10.36076\/ppj.2008\/11\/833","article-title":"Preliminary results of randomized equivalence trials of fluoroscopic caudal epidural steroid injection in managing chronic low back pain: part 4. Spinal stenosis","volume":"11","author":"Manchikanti L","year":"2008","journal-title":"Pain Physician."},{"key":"e_1_2_13_43_1","first-page":"187","article-title":"Fluoroscopically guided caudal epidural steroid injections for lumbar spinal stenosis: a retrospective evaluation of long term efficacy","volume":"7","author":"Barre L","year":"2004","journal-title":"Pain Physician."},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(03)00472-6"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.11.SPINE09531"},{"key":"e_1_2_13_46_1","first-page":"582","article-title":"The current state of minimally invasive spine surgery","volume":"93","author":"Kim CW","year":"2011","journal-title":"J Bone Joint Surg Am."},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000347007.95725.6F"},{"key":"e_1_2_13_48_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.36076\/ppj.2010\/13\/35","article-title":"New image guided ultra\u2010minimally invasive lumbar decompression method: the mild procedure","volume":"13","author":"Deer T","year":"2010","journal-title":"Pain Physician."},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199201000-00001"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199601010-00022"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B4.22050"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199608010-00012"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707136"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53254.x"},{"key":"e_1_2_13_55_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.36076\/ppj.2010\/13\/369","article-title":"Mild decompression alternative to open surgery: a preliminary report of a prospective, multi\u2010 center clinical study (MiDAS I)","volume":"13","author":"Chopko BW","year":"2010","journal-title":"Pain Physician."},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.3.2.0129"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.78.5.0695"},{"key":"e_1_2_13_58_1","first-page":"555","article-title":"Retrospective review of patient self\u2010report improvement and post procedure findings for mild","volume":"13","author":"Lingreen R","year":"2010","journal-title":"Pain Physician."},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.2.5.0624"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1082314"},{"key":"e_1_2_13_61_1","first-page":"283","article-title":"Decompressive laminectomy for lumbar spinal stenosis: review of 65 consecutive cases from Tema, Ghana","volume":"26","author":"Andrews NB","year":"2007","journal-title":"West Afr J Med."},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2007.02.006"},{"key":"e_1_2_13_63_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/BLO.0b013e31803799a9","article-title":"Is spinal stenosis better treated surgically or nonsurgically?","volume":"458","author":"Athiviraham A","year":"2007","journal-title":"Clin Orthop Relat Res."},{"key":"e_1_2_13_64_1","first-page":"100","article-title":"Efficacy of unilateral laminectomy for bilateral decompression in lumbar spinal stenosis","volume":"17","author":"Cavuoglu H","year":"2009","journal-title":"Turk Neursurg."},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2007.6.3.229"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.3171\/SPI-07\/12\/579"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-005-0033-4"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-985152"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000163688.17385.9B"},{"key":"e_1_2_13_70_1","first-page":"107","article-title":"Surgical treatment of lumbar spinal stenosis in geriatric population: is it risky?","volume":"38","author":"Kim DW","year":"2007","journal-title":"J Korean Neurosurg Soc."},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1073137"},{"key":"e_1_2_13_72_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000251014.81875.6d"},{"key":"e_1_2_13_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0078-z"},{"key":"e_1_2_13_74_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000245616.32226.58"},{"key":"e_1_2_13_75_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0903-2"},{"key":"e_1_2_13_76_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000188663.46391.73"},{"key":"e_1_2_13_77_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.7.17634"},{"key":"e_1_2_13_78_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2006.47.3.326"},{"key":"e_1_2_13_79_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1022542"},{"key":"e_1_2_13_80_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000255332.87909.58"},{"key":"e_1_2_13_81_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2002.97.2.0213"},{"issue":"2","key":"e_1_2_13_82_1","first-page":"146","article-title":"Microendoscopic decompression laminotomy for the treatment of the lumbar Stenosis","volume":"51","author":"Khoo LT","year":"2002","journal-title":"Neurosurgery."},{"key":"e_1_2_13_83_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000048494.66599.DF"},{"key":"e_1_2_13_84_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000241066.55849.41"},{"key":"e_1_2_13_85_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e31802dabd2"},{"key":"e_1_2_13_86_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-004-0821-2"},{"key":"e_1_2_13_87_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.9.SPINE091012"},{"key":"e_1_2_13_88_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181bfca15"},{"key":"e_1_2_13_89_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31822bb344"},{"key":"e_1_2_13_90_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2012.00565.x"},{"key":"e_1_2_13_91_1","unstructured":"FDA Center for Devices and Radiological Health Orthopedic and Rehabilitation Devices Panel Meeting Friday September 9 2005."},{"key":"e_1_2_13_92_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.338"}],"container-title":["Pain Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpapr.12188","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.12188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T21:37:38Z","timestamp":1696282658000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.12188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,12]]},"references-count":91,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/papr.12188"],"URL":"https:\/\/doi.org\/10.1111\/papr.12188","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,12]]}}}