In 2000, Nachemson and coll. published a book about modern treatment of spine related pathologies. They concluded that evidence regarding efficiency of surgical and non surgical treatments of lumbar spinal stenosis was poor. Despite this and the fact that the precise mechanism of pain is still unknown, surgical treatment of spinal stenosis, mainly consisting in a laminectomy, has made it through the years. More recently, higher quality scientific publications have brought significant evidence that surgery yields better short and long term functional results, than non surgical conservative treatment. This advantage might also compensate for possible internistic complications in a usually older and fragile population.