On January 10, 2021, Atul Goel will make a presentation called

“New revolutionary Concepts”  

In degenerative spinal disease muscle weakness related spinal ‘vertical’ instability is the primary issue.  

Disc changes, osteophyte formation, bulging of the inter-vertebral ligaments that include posterior longitudinal ligament and ligamentum flavum and consequent reduction in the spinal and root canal dimensions are all secondary to spinal instability. 

Instability is the cause and stabilization of the affected spinal segments is the treatment. 

Compression of the cord/root is always secondary. Decompression is never the treatment. 

Same concept holds good in the treatment of OPLL (ossification of posterior longitudinal ligament).   

The term lumbar canal stenosis is a mis-nomer and can misdirect the treatment. It should be renamed as lumbar spinal instability.