Lumbar spinal stenosis is a common cause of low back pain and low back and leg pain, mostly due to degenerative hyperplasia or other factors that promote further narrowing of the spinal canal on top of the existing developmental narrowing of the spinal canal, which compresses the cauda equina nerve located in the spinal canal and produces symptoms. Lumbar spinal stenosis is usually referred to as central (main spinal canal) spinal stenosis. There are many causes of spinal stenosis, which can generally be divided into two categories: congenital (primary) and acquired (secondary). Congenital spinal stenosis is commonly caused by congenital malformations and lack of development of the spinal canal, which is universally narrowed, while acquired spinal stenosis is often caused by thickening of the spinal canal wall (bones and ligaments) and protrusion of soft tissue or neoplastic organisms around the spinal canal into the lumen. The clinical symptoms of spinal stenosis mainly manifest intermittent claudication and occur mostly in men over middle age. Typical clinical manifestations of lumbar spinal stenosis are: bilateral neurological claudication, intermittent radiating burning sensation, numbness, distension or weakness in the thighs or calves, mostly from nerve root compression; symptoms are aggravated by prolonged standing, activity or lumbar hyperextension and alleviated by sitting, lying or lumbar flexion. Symptoms can be asymmetrical and vary from day to day, or alternate between left and right sides. The pain can be reduced by changing the activity and position. Sudden onset of pain in the lower extremities or sudden aggravation of existing pain symptoms are mostly indicative of concomitant disc herniation or acute nerve blood supply deficiency. In general, the diagnosis can be made by history, clinical examination and plain film examination. The main auxiliary examinations are: X-ray, CT, MRI, etc. In the past, early surgery was advocated for symptomatic lumbar spinal stenosis because the disease was considered to be progressive. However, recent research results show that a phase of conservative treatment should be given before determining whether surgery is needed. Non-surgical treatments include: physical therapy, medication, activity modification, application of braces and epidural hormone closure. The drugs are mainly non-steroidal antipyretic and analgesic drugs, and the physiotherapy mainly includes heat therapy, ice therapy, ultrasound, massage, electrical stimulation and traction. In addition to reducing the inflammatory response caused by nerve compression, these methods can improve local blood circulation, reduce sterile inflammatory response, eliminate congestion, edema, increase the intracorporeal volume of the spinal canal, relieve nerve compression and reduce muscle spasm, thus reducing local symptoms. Lumbar girth protection can increase the stability of the lumbar spine to reduce pain, but should be applied for a short period of time to avoid lumbar muscle atrophy.2. Surgery should be considered when the patient’s quality of life is reduced and when the patient is intolerant due to pain and when conservative treatment is ineffective. The main surgical modality is lumbar spinal stenosis decompression, which is basically divided into two categories: extensive laminectomy decompression and limited decompression. The goal is to enlarge the spinal canal and remove any compression of the cauda equina or nerve roots. The difference between the two procedures lies in the scope of decompression: the former has a complete scope of decompression but is prone to spinal instability; the latter provides limited decompression, removing fewer bony abnormal structures to preserve more posterior bone and ligament structures, which, in theory, can reduce the occurrence of postoperative spinal instability. The specific surgical approach needs to be flexibly adopted by the clinician according to the patient’s specific situation. The efficacy of surgical decompression for lumbar spinal stenosis is generally considered to be good, but there are many factors that affect the long-term surgical outcome, such as the patient’s age, the type and extent of the lesion, the decompression method, and the stability of the lumbar spine. It is important to emphasize that the goal of surgery is to reduce symptoms rather than cure them. Nor is it possible to restore normalcy to discs and small joints that have undergone degenerative changes. It is also not possible to abort the natural progression of degenerative changes in the spine. In the long term postoperative follow-up, there is still the possibility of regrowth of the growth into the decompression zone, causing recurrence of neurological compression symptoms.