Medication: Analgesic and anti-inflammatory drugs such as Fotarine and Fenbid can be used for aseptic inflammation of the nerve roots. Medical sports: can strengthen the muscular exercise of the back extensor and abdominal muscles to increase the stability of the lumbar spine, thus delaying the evolution of lumbar joint degeneration. Playing Taijiquan has a better effect on this disease. Lumbar girth protection can increase the stability of the lumbar spine to reduce pain, but it should be applied for a short period of time to avoid lumbar muscle atrophy. Surgical treatment: If the above conservative treatment is ineffective or the effect is not obvious, surgical treatment can be considered. What are the indications for surgery for lumbar spinal stenosis? The indications for surgery are: (1) Back and leg pain after activity, which affects life and work and is not cured by conservative treatment. (2) Progressive claudication worsens, or the standing time is gradually shortened. (3) Nerve function is significantly deficient. The purpose of surgery is to relieve the compression of nerve tissue and blood vessels in the spinal canal, nerve root canal or intervertebral foramen. The common surgical procedures are laminectomy and nerve root decompression. What is lumbar spinal stenosis of the lateral saphenous fossa? In some clinical cases, a lumbar disc herniation is diagnosed before surgery, but there is no herniated disc or only a small protrusion during surgery. The main lesion is lateral stenosis of the spinal canal compressing the nerve root, called lateral saphenous stenosis, to distinguish it from main spinal stenosis. The lateral saphenous fossa refers to the narrowing gap of the spinal canal extending laterally, which mainly occurs in the trilobar spinal canal and is most typical in the lower two lumbar vertebrae. The lateral saphenous fossa is generally considered to be narrow if the anterior and posterior diameters are less than 3 mm, normal if they are more than 5 mm, and relatively narrow if they are in between. So, why is the lateral saphenous fossa narrowed? Congenital factors can cause lateral saphenous stenosis. The deep lateral saphenous fossa and small anterior-posterior diameter of the trilobar spinal canal are developmentally predisposed to stenosis. Another important factor contributing to stenosis is degeneration. Degeneration of the intervertebral disc with calcification of the fibrous annulus, hyperplasia of the posterior superior edge of the vertebral body, which protrudes from the anterior to the posterior into the lateral saphenous fossa; supra-articular protrusion of the inferior vertebrae after disc stenosis; hyperplasia of the isthmus, hypertrophy and calcification of the ligamentum flavum, which protrudes from the posterior into the lateral saphenous fossa; and anterior or posterior slippage of the degenerated vertebral body can all contribute to lateral saphenous fossa stenosis. What are the manifestations of lumbar lateral saphenous stenosis and how is it treated? The disease occurs mostly in middle age and above, more in men than women, which may be due to the heavy load in men, the more cloverleaf-shaped lower lumbar spinal canal, and the small preserved gap around the nerve roots, which predisposes to compression symptoms. Patients generally have a long history of low back pain and low back and leg pain, leg pain is often heavier than those with herniated discs, and exertion or trauma can induce pain or make symptoms significantly worse. Neurogenic intermittent claudication is progressive, and the claudication distance decreases from hundreds of steps to tens of steps, and is relieved after squatting or sitting down to rest. Lower extremity pain radiates along the lumbar or sacral innervation zone. Lateral saphenous stenosis is a mechanical compression of the nerve root by adjacent structures and is not amenable to conservative treatment. Traction is only suitable for those with less severe compression. For diagnosed cases, surgical treatment should be chosen to completely relieve the nerve root compression, and the surgical technique should be improved to avoid unnecessary expansion of decompression, which may affect the stability of the spinal intersegments. Are lumbar disc herniation and lumbar spinal stenosis the same thing? Lumbar spinal stenosis refers to any form of narrowing of the spinal canal, nerve root canal, and intervertebral foramen due to congenital developmental causes or various factors of acquired degeneration, causing compression or irritation of the cauda equina or nerve roots and a series of clinical manifestations of the syndrome. The clinical manifestations of lumbar spinal stenosis are: (1) Intermittent claudication: When the patient stands upright or walks, different sensations such as pain, numbness, heaviness, and weakness occur in the lower extremities that gradually increase, so that the patient has to change his or her posture or stop walking, and the symptoms can be reduced or disappear after squatting or resting for a few moments, and continue to stand or walk, and the symptoms reappear and are forced to rest again. Because of repeated walking and resting, the walking distance is gradually shortened. Intermittent claudication may not occur when climbing hills or riding bicycles. (2) Lower back pain: Most patients with lumbar spinal stenosis have a history of lower back pain or are accompanied by lower back pain. The pain is generally mild and is relieved or disappears with bed rest, and the lumbar forward flexion is not restricted, while the posterior extension is often limited. (3) Nerve root compression symptoms and signs: Nerve root canal stenosis causes corresponding symptoms and signs of nerve root compression or irritation. Some patients exhibit intermittent claudication, while others exhibit persistent radiological nerve root symptoms, mostly soreness, numbness, swelling, and tingling, with varying degrees of pain. The site of nerve root symptoms is related to the compressed nerve root, and manifests as decreased pinprick sensation, abnormal pain sensation, decreased muscle strength and abnormal tendon reflexes in the corresponding nerve root distribution area. (4) Cauda equina compression: Lumbar spinal stenosis can lead to compression of the cauda equina nerve, with symptoms and signs in the saddle area and symptoms of the sphincter, and in severe cases, symptoms of urinary and fecal and sexual disorders. Diagnosis of lumbar spinal stenosis: Appropriate auxiliary examination methods should be selected according to clinical manifestations, such as X-ray plain film, myelography, CT scan, CT myelography, MRI, etc. by various projection methods to make accurate localization, qualitative and quantitative diagnosis. The biggest difference with lumbar disc herniation is that lumbar disc herniation generally does not have the three major symptoms of intermittent claudication, inconsistency between the chief complaint and objective examination, and limitation of lumbar back extension. The flexion neck test and straight leg raising test of lumbar disc herniation are mostly positive, while the lumbar spinal stenosis is negative. In addition, there is a clear difference between lumbar spinal stenosis and lumbar disc herniation in imaging, i.e., lumbar spinal stenosis shows less than normal sagittal signs of the spinal canal on CT, MRI, and myelography, while lumbar disc herniation does not. The two are two separate diseases, but at the same time there is some connection, and they can occur together, and the percentage of concomitant occurrence is quite high, which is the reason why people tend to confuse them. This is because in the later stages of lumbar disc herniation, synovial inflammatory exudative reaction, articular cartilage wear and tear and fragmentation occur in the corresponding small joints, leading to the development of hyperplastic bone flaps at the lateral posterior edge of the vertebral body and at the articular eminence, secondary to lumbar spinal stenosis. When the two diseases occur simultaneously, the patient may show symptoms and signs of both, and clinical diagnosis is not difficult.