Spinal stenosis is primarily caused by degeneration of the spine. As individuals age, the spine begins to show signs of intervertebral disc degeneration, which can lead to subsidence or bulging. The facet joints and the ligament inside the spinal canal (ligamentum flavum) also grow and thicken, contributing to the narrowing of the spinal cavity. This condition is more common in people over the age of 50 and affects both women and men equally. Several factors can contribute to spinal stenosis: 

• Age-related spinal joint degeneration
• Work-related causes, depending on the nature of work
• Genetic factors
• Smoking

The spinal cavity houses nerves that innervate muscles and provide skin sensations. When the spinal cavity narrows to a certain extent, it can compress these nerves, resulting in back or hip pain that radiates down the leg, numbness, or weakness. Some patients cannot walk long distances without experiencing leg pain that forces them to stop (claudication). In some cases, patients may also have difficulty controlling urination and defecation.

Additional investigations to identify the cause of nerve compression include a Magnetic Resonance Imaging (MRI) scan. The MRI can highlight the pathology, location, and severity of the nerve compression and can be used in conjunction with a plain X-ray.

For patients with mild symptoms, treatment options include:

• Lifestyle modifications: avoiding heavy lifting and maintaining a healthy weight
• Strengthening back/core muscles
• Medication
• Physical therapy
• Epidural steroid injections

For individuals with severe symptoms, such as severe leg pain, short walking distances, or symptoms that significantly interfere with daily life, surgery can be an effective treatment. There are many types of surgeries available, depending on each patient's specific needs:

1. Surgery to remove tissue and bone that compress the spinal nerve. This can currently be done through a microscope or endoscope, resulting in a small incision, minimal injuries, short hospital stay, and rapid recovery.
2. Surgery to insert a spinal implant fixation and remove the tissue and bone that compress the spinal nerve. This is ideal for patients with severe back pain from spinal joint degeneration, spinal deformity, or spinal instability."