title: Surgical management of lumbar spinal stenosis: a survey among Norwegian spine surgeons.
abstract: Symptomatic lumbar spinal stenosis (LSS) is the most common reason for lumbar surgery in the elderly. There is growing evidence that decompressive surgery offers an advantage over non-surgical management for selected patients with persistent severe symptoms. Based on treatment traditions, open laminectomy has been the gold standard surgical treatment, but various other surgical and non-surgical treatments for LSS are widely used in clinical practice. Therefore, we conducted a survey study to capture potential diversities in surgeons' management of LSS in Norway.
  
  
  
  All spine surgeons in Norway were contacted by e-mail and asked to answer a 20-item questionnaire by using an Internet-based survey tool. We asked eight questions about the respondent (gender, surgical specialty, workplace, experience, number of surgeries performed per year, use of magnification devices) and 12 questions about different aspects of the surgical treatment of LSS (indication for surgery and preoperative imaging, different surgical techniques, clinical outcome).
  
  
  
  The questionnaire was answered by 51 spine surgeons (47% response rate). The preferred surgical technique for LSS in Norway is microdecompression via a unilateral approach and crossover technique, followed by microdecompression via a bilateral approach. Other techniques are not much used in Norway.
  
  
  
  Most Norwegian spine surgeons use minimally invasive decompression techniques in the surgical treatment of LSS, and unilateral microsurgical decompression with crossover decompression is the preferred technique. Where evidence is lacking (e.g., fusion procedures), there is a larger variation of opinions and preferred procedures among Norwegian spine surgeons.
authors.affiliation: Department of Neurosurgery, Stavanger University Hospital, NO, 4068, Stavanger, Norway. clemens.weber@gmail.com.
authors.forename: Clemens
authors.identifier: 0000-0001-7007-5719
authors.initials: C
authors.lastname: Weber
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Orthopedic Surgery, Innlandet Hospital Trust, Lillehammer, Norway.
authors.forename: Greger
authors.initials: G
authors.lastname: Lønne
authors.affiliation: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Vidar
authors.initials: V
authors.lastname: Rao
authors.affiliation: Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.|Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Asgeir S
authors.initials: AS
authors.lastname: Jakola
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Solheim
authors.affiliation: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Ulf
authors.initials: U
authors.lastname: Nerland
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway.|Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Ivar
authors.initials: I
authors.lastname: Rossvoll
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway.
authors.forename: Øystein P
authors.initials: ØP
authors.lastname: Nygaard
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Wilco C
authors.initials: WC
authors.lastname: Peul
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Sasha
authors.initials: S
authors.lastname: Gulati
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000069471:Neurosurgeons / Q000706:statistics & numerical data*; D009664:Norway; D000072161:Orthopedic Surgeons / Q000706:statistics & numerical data*; D013130:Spinal Stenosis / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Lumbar spinal stenosis; Spine surgery; Surgical management; Survey