Degeneration of the lumbar spine is described as lumbar spondylosis or degenerative disc disease and may lead to spinal stenosis (narrowing of the spinal canal), vertebral instability and/or malalignment, which may be associated with back pain and/or leg symptoms. This review considers the available evidence on the procedures of spinal decompression (widening the spinal canal or laminectomy), nerve root decompression (of one or more individual nerves) and fusion of adjacent vertebrae. There is moderate evidence that instrumentation can increase the fusion rate, but any improvement in clinical outcomes is probably marginal. The effectiveness of intra-discal electrotherapy (IDET) remains unproven. Only preliminary results are available on disc replacement and it is not possible to draw any conclusions on this subject.
Surgery for degenerative lumbar spondylosis
8 October 2008
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