Wow- how much time do you have. Books have been written on this subject. I will give you the Readers Digest version. Lumbar spinal stenosis has many variations including central stenosis, lateral recess stenosis and foraminal stenosis. Most people mean central stenosis when they say lumbar spinal stenosis so we will stick with that.
There are two types of lumbar spinal stenosis- stenosis without slip and stenosis associated with degenerative spondylolisthesis. If there is no slip or instability, a simple decompression surgery like a laminotomy or laminectomy can be performed. There are various versions of the two but the main consideration is to decompress the nerves in the canal.
If there is a slip involved (degenerative spondylolisthesis), then stability of the segments has to be taken into consideration. Flexion/extension X-ray films can indicate how stable or unstable the segments are. If too unstable (and a stability discussion is beyond this forum), then fusion needs to be considered. There are many fusion types and selecting one over the other depends upon the patient and planned activity level after surgery.
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
If this forum has helped you, please let Dr. Corenman know!