Lumbar Spinal Stenosis

Abstract

Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal with cord or nerve root impingement resulting in radiculopathy or pseudoclaudication. It is a common diagnosis that is occurring with increased frequency in sports medicine clinics. Symptoms include radicular pain, numbness, tingling, and weakness. Peripheral vascular disease presents similarly and must be considered in the differential diagnosis. Imaging for LSS usually begins with plain radiographs, but often requires additional testing with MRI or CT myelography. There are currently limited controlled data regarding both conservative and surgical treatment of LSS. Most physicians agree that mild disease should be treated conservatively with medications, physical therapy, and epidural steroid injections. Severe disease appears to be best treated surgically; laminectomy continues to be the gold standard treatment.