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Lumbar Canal Stenosis

lumbar spinal stenosis is a degenerative condition characterized by narrowing of the lumbar spinal canal due to -

■ bony structures

    ■ facet osteophytes

    ■ uncinate spur (posterior vertebral body osteophyte)

    ■ spondylolisthesis

■ soft tissue structures

    ■ herniated or bulging discs

    ■ hypertrophy or buckling of the ligamentum flavum

    ■ synovial facet cysts

Causes -

  • Arthritis
  • Wear and tear on the spine’s bones and joints.
  • Trauma
  • Falls

Symptoms -

  • back pain
  • referred buttock pain
  • leg pain is often unilateral
  • neurogenic claudication
    * pain worse with extension (walking, standing upright)
    * pain relieved with flexion (sitting, leaning over shopping cart, sleeping in fetal position)
  • weakness
  • bladder disturbances - recurrent UTI present in up to 10% due to autonomic sphincter dysfunction
  • cauda equina syndrome (rare)

Investigations -

  • Manual tests
  • CT myelogram
  • MRI
  • Radiographs

Treatment -


  • oral medications, physical therapy, and corticosteroid injections.
  • modalities include-
    *NSAIDS, physical therapy, weight loss and bracing
    *steroid injections (epidural and transforaminal)
    *found to be effective and may obviate the need for surgery
  • Operative.