| Summary: | The new Dartmouth Atlas series on variation in the care of surgical conditions, including this report on the surgical treatment of back pain resulting from spinal stenosis, raises new questions regarding surgical management of both common and less frequently occurring medical conditions. This report carefully details the issues surrounding spinal stenosis, including the physical and economic burden, the difficulties of obtaining a definitive diagnosis, and patient decision-making, and, as in previous Atlas analyses, emphasizes geographic practice variation in surgical treatment rates. However, the report also takes a more longitudinal view. The changes over time in which procedure is favored to treat back pain and spinal stenosis are particularly fascinating, driven as they appear to be by a mix of clinical evidence-including emerging long-term results-and physicians' opinions and personal experience
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