(i) Clinical and radiological assessment

Abstract

In 1910, Sumida ~ gave the first description of lumbar spinal canal stenosis due to fetal chondrodystrophy. In 1945, Sarpyener 2 reported such stenosis due to congenital partial skeletal dysplasia. Thus, both of them reported congenital conditions. The concept of lumbar spinal canal stenosis has been known widely since Verbiest reported on idiopathic developmental stenosis in French in 1949, 3 in Dutch in 1950, 4 and in English in 1954 s and 1955. 6 In 1976, Arnoldi et al. 7 proposed the international definition and classification of lumbar spinal canal stenosis that is still used widely. However, confusion has arisen with regard to interpretation, because it covers both central stenosis (spinal canal stenosis) and lateral stenosis (nerve root canal and intervertebral foramen stenosis), and also covers acquired stenosis due to various degenerative diseases as well as congenital and developmental stenosis. Here, the international classification (Table 1) is interpreted and the problems with it are clarified. Table 1 International classification of lumbar spinal canal stenosis. (Reproduced with permission from Arnoldi et al in Spine 1976; 115: 4-5)