Liu L, Hu HS. Letter to the Editor: Beyond the dichotomy: Integrating precision rehabilitation, patient-centered goals, and nursing leadership in lumbar spinal stenosis care. World J Orthop 2026; 17(5): 115690 [DOI: 10.5312/wjo.v17.i5.115690]
Corresponding Author of This Article
Li Liu, Department of Neonatal Intensive Care Unit, Women and Children’s Medical Center Affiliated to Guangzhou Medical University, No. 9 Jinsui Road, Tianhe District, Guangzhou 510120, Guangdong Province, China. 18818408934@163.com
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Nursing
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Correspondence
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Liu L, Hu HS. Letter to the Editor: Beyond the dichotomy: Integrating precision rehabilitation, patient-centered goals, and nursing leadership in lumbar spinal stenosis care. World J Orthop 2026; 17(5): 115690 [DOI: 10.5312/wjo.v17.i5.115690]
World J Orthop. May 18, 2026; 17(5): 115690 Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.115690
Letter to the Editor: Beyond the dichotomy: Integrating precision rehabilitation, patient-centered goals, and nursing leadership in lumbar spinal stenosis care
Li Liu, Hai-Sheng Hu
Li Liu, Department of Neonatal Intensive Care Unit, Women and Children’s Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Hai-Sheng Hu, Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, Guangdong Province, China
Co-corresponding authors: Li Liu and Hai-Sheng Hu.
Author contributions: Liu L and Hu HS contributed equally to this manuscript and are co-corresponding authors. Hu HS designed the overall concept and outline of the manuscript; Liu L contributed to the writing and editing of the manuscript and illustrations of literature.
AI contribution statement: AI tools were used solely for linguistic refinement. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Li Liu, Department of Neonatal Intensive Care Unit, Women and Children’s Medical Center Affiliated to Guangzhou Medical University, No. 9 Jinsui Road, Tianhe District, Guangzhou 510120, Guangdong Province, China. 18818408934@163.com
Received: October 24, 2025 Revised: December 3, 2025 Accepted: January 14, 2026 Published online: May 18, 2026 Processing time: 207 Days and 7.7 Hours
Abstract
This letter comments on the prospective study by Ayyildiz et al comparing surgical and conservative management for lumbar spinal stenosis. We applaud the authors for demonstrating comparable efficacy in core outcomes with complementary benefits, reinforcing that lumbar spinal stenosis treatment is not one-size-fits-all. While endorsing supervised physical therapy as a crucial first-line option, we propose advancing the discourse by integrating contemporary paradigms. The differential treatment effects on various functional scales underscore the need for precision rehabilitation to match patient phenotypes with optimal interventions. Furthermore, these outcome variations highlight the imperative to define success using patient-important outcomes within a biopsychosocial model, where nursing-led support is vital for self-efficacy and long-term success. Ultimately, we advocate for a shift from a binary choice to an integrated, stepped-care pathway. In this model, all patients commence with nurse-coordinated, precision-based conservative care, with surgery reserved for those who do not achieve their functional goals. This approach optimizes resources, minimizes surgical risks, and positions nursing as central to assessment, education, and personalized care coordination, ensuring treatment aligns with what matters most to the patient.
Core Tip: The management of lumbar spinal stenosis should shift from a binary choice to an integrated, precision-based stepped-care pathway. All patients begin with nurse-coordinated conservative care, including tailored physical therapy and biopsychosocial support. Surgery is reserved for those who do not achieve personal functional goals after this optimized nonoperative phase. This model enhances resource efficiency, minimizes surgical risks, and establishes nursing leadership as central to personalized assessment, education, and care coordination, ensuring treatment aligns with patient-centered outcomes.
