Spinal stenosis is a disease in which the spinal cord and spinal nerve roots are compressed due to narrowing of the spinal canal lumen, resulting in corresponding neurological dysfunction. It is actually a common pathological sign caused by a group of diseases and is clinically named after specific pathological changes, mostly seen in the cervical and lumbar spine, which is prone to injury due to greater mobility. The common causes of spinal stenosis include hypertrophic changes of vertebral joints, disc herniation, posterior longitudinal ligament hypertrophy, laxity of the ligamentum flavum, folds, vertebral subluxation, and rare cartilage dysplasia, deformational osteitis, etc. It is generally divided into congenital (primary) and acquired (secondary). It is divided into cervical spinal stenosis, lumbar spinal stenosis, and thoracic spinal stenosis according to the location. According to the anatomical site, it can be divided into central stenosis, lateral saphenous stenosis, and neurogenic foramen stenosis, etc. Diagnostic points 1. Cervical spinal stenosis (1) General symptoms: neck pain and headache, aggravated by neck activity, and a few patients may have sudden vertigo attacks when the neck is hyperextended or rotated. (2) Those with radicular pain can often radiate to the upper extremities and anterior thorax, and the symptoms worsen with head, neck and upper extremity activities and decrease after rest. It is accompanied by numbness, muscle atrophy, and diminished or absent tendon reflexes in the lesion area. 2.Lumbar spinal stenosis (1)General symptoms: Mainly manifested as lumbar and leg pain, often occurring as radicular radiating neuralgia on one or both sides. Lower limb pain and intermittent claudication, numbness and weakness occur when walking. After squatting or bed rest, the symptoms quickly disappear or are relieved, and the pain is comfortable when bending and worsens when extending backwards, and does not increase significantly when coughing and sneezing. (2) Clinical manifestations: cauda equina or nerve root compression symptoms, radicular sensory disorders in the lower limbs, reduced or absent Achilles tendon reflex, muscle atrophy and weakness in the lower legs, and in severe cases, weakness in both lower limbs, sphincter relaxation, diplegia or light paralysis. 3, auxiliary examination (1) X-ray plain film: cervical and lumbar lateral films can be seen in the disappearance of physiological anterior convexity, narrowing of the vertebral space, lip-like changes in the anterior and posterior edges of the vertebral body, vertebral body subluxation, etc. The anterior-posterior diameter of the spinal canal of cervical 4-7 is less than 14 mm, and the anterior-posterior diameter of the lumbar spine is less than 15 mm, which can be diagnosed as spinal stenosis. (2) Cerebrospinal fluid examination: pressure neck test can show partial obstruction of the spinal canal, and the amount of protein can be increased. (3) CT, MRI examination: it can show the stenosis site and signs such as osteophytes more clearly, and the degree of stenosis can be judged. Treatment 1. Non-surgical treatment: In atypical cases, non-surgical treatment, bed rest, cervical and lumbar traction, physiotherapy, massage and acupuncture should be used first. At the same time, cold and overwork should be avoided to promote the recovery of symptoms of nerve stimulation. 2.Surgical treatment: When symptomatic treatment is ineffective and symptoms are progressively aggravated, surgery such as laminectomy and decompression, osteotomy or dentate ligament severance can be performed. In the case of severe stenosis, it is necessary to amputate the vertebral plate not only high and wide enough, but also to release the hyperplastic bone in the posterior part of the vertebral body (anterior part of the spinal canal) and the lateral saphenous fossa in order to completely release all the compression of the cauda equina and nerve roots.