Acquired lumbar spinal stenosis.

Based on the individual clinical presentation and radiographic findings, an operation that completely decompresses the neural elements in the spinal canal and neural foramina followed by posterior, posterolateral, or interbody fusion, with or without instrumentation should be the procedure of choice in the future. The introduction of pharmacological agents to decrease scarring around the decompressed nerve roots will also increase the number of successful procedures. It must be stressed, however, that any new operative technique must be tested in a rigorous fashion, ideally with a prospective randomized clinical trial.