Recommendations

Document Overview

Design and created by Guideline Central in participation with the North American Spine Society.

Diagnosis And Treatment Of Degenerative Lumbar Spinal Stenosis

North American Spine Society

Publication Date: Jul 1, 2013

Page Last Updated: May 6, 2026

North American Spine Society Recommendation Grades

Grade	Definition
Level of Evidence
Level I	High quality randomized controlled trials High quality prospective studies
Level II	Lesser quality randomized controlled trials Prospective or retrospective studies
Level III	Descriptive case series, opinions of expert panels
Level IV	Case series
Level V	Expert opinion
Grades of Recommendation
A: Recommended	Good evidence (Level I studies with consistent findings) for or against recommending intervention
B: Suggested	Fair evidence (Level II or III studies with consistent findings) for or against recommending intervention
C: Optional	Poor quality evidence (Level IV or V studies) for or against recommending intervention
I: Insufficient	Insufficient or conflicting evidence not allowing a recommendation for or against intervention

Document Overview

Document Title: Diagnosis And Treatment Of Degenerative Lumbar Spinal Stenosis

Authoring Society: North American Spine Society

Document Publication Date: Jul 1, 2013

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.thespinejournalonline.com/article/S1529-9430(13)00423-3/fulltext

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Diagnosis, Management, Rehabilitation, Treatment

Keywords: degenerative disc disease, degenerative lumbar spinal stenosis, lumbar stenosis

Inclusion Criteria: Female, Male, Adult, Older Adult

Health Care Settings: Ambulatory, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Technical Review

Number of Source Documents: 1,424

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No