Recently, the Dartmouth Medical School and the Institute for Health Policy and Clinical Practice conducted a study on factors influencing the outcomes of surgical and non-surgical treatment of spinal stenosis. The results of the study showed that surgical outcomes were significantly better than non-surgical outcomes for patients with spinal stenosis after strict case entry criteria, regardless of other patient characteristics, except for smoking. Surgery should be chosen when the patient has failed to respond to systematic conservative treatment, has intolerable pain and has a reduced quality of life, such as weakness and limitation in walking; and when symptoms and signs are consistent with imaging findings. It must be emphasized that surgery cannot abort the natural progression of degenerative changes in the spine, nor can it normalize the discs and small joints that have undergone degenerative changes. The goal of surgical treatment is to reduce or eliminate symptoms and improve the quality of life through nerve decompression and stabilization of the spine.