Systematic review of treatment for Lumbar spinal stenosis

Purpose
To summarise recommendations from a national clinical guideline from the Danish Health Authority about 10 surgical and non-surgical interventions for lumbar spinal stenosis in patients above 65 years of age.
Methods
A multidisciplinary working group formulated recommendations based on the GRADE approach.
Results
Seven of the recommendations were based on randomised controlled trials and three on professional consensus. Management of lumbar spinal stenosis should include supervised exercise, postsurgical supervised exercise and decompression surgery. The guideline recommend against manual therapy, paracetamol, NSAIDs, opioids, neurogenic pain medication, muscle relaxants and decompression combined with instrumented stabilising fusion surgery.
Conclusion
The recommendations are based on low to very low quality of evidence and professional consensus, and the
true treatment effect may therefore be different from the estimated effects, which is why results should be interpreted with caution. The working groups recommends intensified research in relation to all aspects of management of lumbar spinal stenosis should be intensified.