Lumbar spinal stenosis

Lumbar spinal stenosis is a condition where the spinal canal area is reduced, leading to compression of neural structures.

A broad range of pathologies can cause lumbar spinal stenosis. However, degenerative etiologies are the most common cause, which includes one or more of the following:

1. Disc herniation
2. Ligamentum flavum hypertrophy
3. Facet arthropathy
4. Synovial cyst
5. Spondylolisthesis

In cases of degenerative spinal stenosis, symptoms usually progress over time.

Other non-degenerative etiologies of lumbar spinal stenosis include:

• Hematoma
• Infection/abscess
• Tumor
• Trauma
• Lipomatosis

These can present with acute symptoms as described below and may be a surgical emergency requiring immediate decompression.

The presentation may include neurogenic claudication, sensorimotor deficits, difficulties with gait, bowel/bladder issues, and lower back pain.

In some situations, stenosis occurs together with spondylolisthesis and instability, which can manifest with mechanical back pain (eg, pain with movement from sitting to standing).