Spinal stenosis — master index¶
Last curated: 2026-08-30 · status: audited · 18 curated wiki pages · 350-paper master bibliography · 6 landmark notes · 21-document guideline registry · >100 sourced statistics rows · 8 live-verified organizations · 26 open questions + 14 unconnected-dots junctions
The condition in five sentences. Spinal stenosis becomes a clinical disorder when central-canal, lateral-recess or foraminal narrowing produces a concordant neural syndrome; imaging-only narrowing is common, including a pooled 11% (95% CI 5–18%) radiological prevalence in asymptomatic samples (Jensen 2020, PMID 32095908). Lumbar disease is dominated by posture-dependent neurogenic claudication and loss of walking, while cervical cord compression can produce progressive hand dysfunction, gait imbalance, long-tract signs and falls. Moderate lumbar symptoms often remain stable—leg pain worsened in 13% and only 7% crossed to surgery over 3.3 years in one cohort—whereas modeled neurological stability in mild DCM fell from 91% at one year to 75% at five years (Wessberg 2017, PMID 28417234; Sarraj 2024, PMID 37549831). Multimodal rehabilitation is the best-supported first lumbar strategy for stable disease; decompression helps selected persistent disabling cases, but epidural steroid adds little over anesthetic and fusion adds no routine disability benefit for many patients with degenerative spondylolisthesis (Friedly 2014, PMID 24988555; Austevoll 2021, PMID 34347953; Kgomotso 2024, PMID 39111800). Progressive DCM and cauda-equina dysfunction are the safety-critical exceptions, and the central research problem across phenotypes is predicting individual benefit and deterioration from clinical pattern, objective function and anatomy rather than scan severity alone.
Start here: overview.md. Frontier: OPEN-QUESTIONS.md. Growth history: LOG.md. Deliberate sibling boundary: degenerative disc disease covers discogenic axial pain and structural disc change; this condition covers neural compression syndromes.
Reading paths¶
- Lumbar clinical path — overview → lumbar phenotype → diagnosis → rehabilitation → injections/procedures → decompression → fusion question
- Cervical cord path — cervical stenosis and myelopathy → diagnosis → cervical surgery → frailty/perioperative risk → safety
- Measurement and science path — anatomy/imaging → outcomes/walking → biomarkers/digital mobility → trials landscape
- Evidence-governance path — guidelines → guideline registry → statistics → bibliography
- Human and unknowns path — patient experience → patient-voice themes → open questions
Pages¶
| Section | File | Scope | Status |
|---|---|---|---|
| Foundations | overview.md | Lumbar/cervical phenotypes, diagnosis and treatment map | curated |
| Foundations | anatomy-classification-and-imaging.md | Central, lateral recess, foraminal stenosis and measurement limits | curated |
| Foundations | epidemiology-and-natural-history.md | Definition-stratified prevalence, trajectories, progression and burden | curated |
| Lumbar | lumbar-stenosis-and-neurogenic-claudication.md | Classic phenotype, walking limitation and boundary conditions | curated |
| Cervical | cervical-stenosis-and-myelopathy.md | Cord compression, myelopathic signs, progression and timing | curated |
| Clinical | diagnosis-and-differential.md | History, neurological examination, vascular claudication and mimics | curated |
| Clinical | conservative-and-rehabilitation-care.md | Education, exercise, manual therapy, medicines and walking programs | curated |
| Clinical | injections-and-minimally-invasive-procedures.md | Epidural injection, percutaneous decompression and devices | curated |
| Lumbar surgery | lumbar-decompression.md | Indications, techniques, outcomes, recurrence and complications | curated |
| Lumbar surgery | decompression-versus-fusion.md | Instability/spondylolisthesis, randomized trials and reoperation | curated |
| Cervical surgery | cervical-decompression-and-fusion.md | Anterior/posterior strategies and myelopathy outcomes | curated |
| Perioperative | older-adults-frailty-and-perioperative-risk.md | Frailty, cognition, bone health, delirium and shared decisions | curated |
| Measurement | outcomes-and-walking-measurement.md | ODI, Zurich scale, mJOA, objective walking and patient priorities | curated |
| Guidance | guidelines.md | NASS, WFNS, Japanese and DCM recommendations | curated |
| Frontier | biomarkers-and-digital-mobility.md | Gait, imaging, fluid and predictive candidates | curated |
| Frontier | clinical-trials-landscape.md | Rehabilitation, procedures, surgery and device trials | curated |
| Human | patient-experience-and-advocacy.md | Mobility loss, falls, waiting, information and access | curated |
| Safety | red-flags-and-safety-concerns.md | Cauda equina, progressive myelopathy, falls, infection and deterioration | curated |
Literature layer¶
| Artifact | Contents |
|---|---|
| BIBLIOGRAPHY.md | 350 live-PubMed-verified papers with topic and cited-by mapping |
| notes/ | Six landmark notes: prevalence, epidural trial, SPORT, Swedish fusion trial, NORDSTEN-DS and DCM guideline |
| guidelines/REGISTRY.md | 21 documents/modules across NASS, WFNS, Italy, Japan, AO Spine/CSRS, ACR, AAN, MIST and ISSLS; succession and disagreements |
| statistics/STATISTICS.md | >100 population-, method- and comparator-specific rows plus eight caveats/conflicts |
| patient-voice/README.md | Method, ethics and coverage limits |
| patient-voice/organizations.md | Eight organizations fetched live across six regional groupings |
| patient-voice/themes.md | Eight aggregate themes, each supported by at least two sources |
| patient-voice/sources.md | Annotated qualitative, quantitative and public-source ledger |
Curation state¶
The condition is audited as of 2026-08-30. All 18 planned pages passed a fresh-session claim-to-citation audit and are status: curated; 350 unique PMIDs were re-fetched through PubMed E-utilities, all eight displayed NCT records were re-fetched individually through ClinicalTrials.gov API v2, and page references were reconciled to the master bibliography. ClinicalTrials.gov coverage remains a dated snapshot: condition queries returned 414 records for lumbar spinal stenosis and 57 for degenerative cervical myelopathy on 2026-08-30. The absence searches and their dated, positively stated evidence gaps remain in the relevant pages and OPEN-QUESTIONS.md.