• Medical Outcomes Study 36-item Short Form Health Survey
• Beck Depression Inventory
• Oswestry Low Back Pain Disability Scale
• MODEMS questionnaires
• physical impairments and function, including lower leg strength, reflexes, walking tolerance on a treadmill, and two-stage treadmill test

• Beck Depression Inventory [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]
• Oswestry Low Back Pain Disability Scale [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]
• MODEMS questionnaires [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]
• Physical impairments and function, including lower leg strength, reflexes, walking tolerance on a treadmill, and two-stage treadmill test [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]

• Beck Depression Inventory
• Oswestry Low Back Pain Disability Scale
• MODEMS questionnaires
• physical impairments and function, including lower leg strength, reflexes, walking tolerance on a treadmill, and two-stage treadmill test

Lumbar spinal stenosis (a narrowing of spaces in the backbone that results in pressure on the spinal cord and/or nerve roots) is a condition that occurs frequently, particularly in the elderly. This condition can lead to significant pain and limit a person's ability to function. Moreover, doctors disagree about the best way to treat people with lumbar spinal stenosis.

In this study we will compare surgical treatment of lumbar spinal stenosis with nonsurgical treatment using physical therapy. The results of this study should help clarify which treatment strategies are the most effective for patients with lumbar spinal stenosis.

Lumbar spinal stenosis is a frequently encountered condition, particularly in the elderly, which can lead to significant pain and functional limitations. The prevalence of this condition is growing as the population continues to age. Substantial controversy exists regarding the management of lumbar spinal stenosis. Surgery has traditionally been the treatment of choice, although physicians typically recommend a trial of nonsurgical care prior to surgery. The most effective means of nonsurgical treatment has not been identified, although a "standard" regimen has been developed.

There is presently no evidence in the literature regarding the relative effectiveness of surgical versus nonsurgical treatment of lumbar spinal stenosis, or the efficacy of the standard nonsurgical treatment approach. This randomized clinical trial will compare surgical decompression versus nonsurgical treatment (i.e., physical therapy) of lumbar spinal stenosis. The results of this study should help clarify which treatment strategies are the most effective for patients with lumbar spinal stenosis.

• Procedure: Surgical decompression
• Procedure: Physical therapy

• Experimental: Participants will undergo surgery for spinal stenosis.
• Experimental: Participants will undergo physical therapy for spinal stenosis.

Inclusion Criteria:

• Imaging evidence of stenosis
• Unable to walk more than 1/4 of a mile
• No prior surgery for stenosis
• Consents to surgery
• Speaks English

Exclusion Criteria:

• Presence of dementia or organic brain syndrome
• Coronary artery disease, recent myocardial infarction, pulmonary or vascular disease
• Spondylolisthesis (> 5 mm slippage)
• Severe osteoporosis
• Metastatic cancer