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Sager Hanna MB, BCh, BAO, Section of Neurosurgery and Section of Orthopedic Surgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba.
Perry Dhaliwal MD, MPH, FRCSC, Assistant Professor of Neurosurgery, Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba.
Abstract
Lumbar canal stenosis is an anatomical term used to describe narrowing of the spinal canal either congenitally or from age-related degenerative changes. It refers to a structural finding that may or may not be symptomatic. A decrease in canal diameter can lead to compression of the neural components, causing a constellation of symptoms. Family physicians should familiarize themselves with the various presentations of canal narrowing and the available diagnostic and treatment options.
Key Words: lumbar spinal stenosis, neurogenic claudication, back pain, radiculopathy.
Introduction and Background:
Narrowing of the lumbar spinal canal, lumbar canal stenosis (LCS), is an inevitable result of the degenerative changes associated with aging. It varies in degree and may or may not become symptomatic. When symptoms do arise, they can present as low back pain, lumbar radiculopathy or neurogenic claudication.1 Rapid and severe compression can cause cauda equina syndrome, a surgical emergency, that is not discussed here. This article covers the pathogenesis, clinical presentation, and imaging recommendations for patients presenting with neurogenic claudication or lumbar radiculopathy. We present basic concepts in decision making for the array of surgical management strategies aimed at symptomatic lumbar spinal stenosis.