1.What is lumbar spinal stenosis? Lumbar spinal stenosis is due to degenerative changes in the lumbar spine, caused by disc protrusion, ligamentous hypertrophy, osteophytes and spinal stenosis, compression of nerves, mostly seen in middle-aged and elderly people, mainly manifested as lumbar pain accompanied by weakness of both lower limbs, walking restrictions, typical symptoms of medical terminology called “intermittent claudication”, that is, walking after the weakness of both lower limbs, squatting This is due to the fact that the volume of the spinal canal increases when bending over, which partially relieves nerve compression. In addition, some of them show soreness, numbness, pain and coldness in both lower limbs. Zhao Hong, Department of Orthopedics, Peking Union Medical College Hospital 2.How to treat lumbar spinal stenosis? The treatment of lumbar spinal stenosis can be conservative, mainly drugs to relieve the symptoms. For serious spinal stenosis, when drugs cannot release the compression and conservative treatment is ineffective, surgery is needed, which is mainly to make an incision from the back of the lumbar area and perform spinal decompression, that is, to remove the hyperplastic bone and ligament, expand the spinal canal and release the compression of the nerve by the hyperplastic bone. 3.What is “steel nailing”? Why do I need a steel nail? After the lumbar spinal stenosis, the stability of the spine itself has been reduced, and then the stability is even worse after the surgery to remove the hyperplastic bone, so it is necessary to use internal fixation, that is, “steel nails” to refix the spine and rebuild stability, generally speaking, the material is titanium alloy. 4.Do I need to take out the “steel nail”? How many years is the life expectancy? Generally speaking, the internal fixation does not need to be taken out, in addition to the use of internal fixation, the surgery is usually combined with the use of “bone grafting” materials, that is, laying a lot of bone, which comes from the bone cut off during surgery, but also can use some bone materials, the bone and its own bone grow together in the future, to achieve the purpose of spinal fusion. 5. Is it risky to operate on elderly people at such an old age? Will they be paralyzed? Spinal surgery is relatively risky, so you need to choose an experienced surgeon. Generally speaking, the lumbar spine area is already the cauda equina, which is the end of the spinal cord, and complete damage is unlikely. In addition, age is not an absolute contraindication. An 80-year-old may be in good health all the time and can tolerate the surgery, while a 50-year-old may have severe combined cardiopulmonary disease and cannot tolerate the surgery, and needs to be evaluated before the surgery to see if the cardiopulmonary function can tolerate the surgery. Hypertensive diabetic patients with smooth control can be operated. 6.What will happen if I don’t have surgery? Lumbar spinal stenosis is a degenerative change, which means that it will continue to worsen with age, manifested by shortened walking distance, severe back and leg pain, loss of mobility, affecting the quality of life, and even nerve paralysis or nerve damage if the compression is severe, manifested by foot drop and urinary and fecal incontinence.