A recent review by McGregor, et al, mentions a few studies that support pre surgery rehabilitation. There is a suggestion by McGregor, et al, that the older age of spinal stenotic patients puts them at greater risk for comorbidiites and have a greater need for rehabilitation to improve outcomes. Along the same lines there is evidence from Nielsen, et al, whose study included both pre and post operative rehab with good results. This included both length of stay in the hospital and functional recovery. McGregor, et al, suggest that there is usefulness in looking at the entire care pathway in a more holistic way rather than simply focusing on the surgery. Based on these few examples there is evidence that pre surgical rehab can improve surgery and there is a need for more research in this area.