Lumbar Spinal Stenosis - History

History

A description of LSS was published by Sachs and Frankel in 1900, but the first clinical description of LSS is usually attributed to the Dutch neurosurgeon Henk Verbiest, whose report appeared in 1954.

Spinal stenosis began to be recognized as an impairing condition in the 1960s and 1970s. Porter and colleagues discovered that individuals who experience back pain and other symptoms are likely to have smaller spinal canals than those who are asymptomatic. Rothman reported that a normal sized lumbar canal is rarely encountered in persons with either disc disease or those requiring a de-roofing (laminectomy) procedure.

During the 1970s and 1980s, multiple case reports showed successful surgical treatment rates based on subjective assessment by surgeons, "before studies with more standardized assessment techniques began to emerge in the 1990s". Studies "rarely reported on the clinical course of patients with stenosis who were treated with observation, and many surgeons held to the belief that the natural history was poor". In 1992, Johnsson, Rosén and Udén described the natural history of LSS, with different conclusions about prognosis and treatment: "70% of patients reported no significant change in symptoms, 15% showed significant improvement, whereas 15% showed some deterioration. The investigators concluded that observation is a reasonable treatment option for lumbar stenosis and that significant neurologic deterioration is rare."

As of 2010, there are "no widely accepted diagnostic or classification criteria for the diagnosis of LSS and, as a consequence, studies use widely differing eligibility criteria that limit the generalisability of reported findings" and "few studies have examined how its prevalence or incidence is changing".