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Review
. 2010 Apr;24(2):253-65.
doi: 10.1016/j.berh.2009.11.001.

Lumbar spinal stenosis

Stephane Genevay  1 , Steven J Atlas
Affiliations
Review

Lumbar spinal stenosis

Stephane Genevay et al. Best Pract Res Clin Rheumatol. 2010 Apr.

Abstract

Lumbar spinal stenosis (LSS) is most commonly due to degenerative changes in older individuals. LSS is being more commonly diagnosed and may relate to better access to advanced imaging and to an ageing population. This review focusses on radicular symptoms related to degenerative central and lateral stenosis and updates knowledge of LSS pathophysiology, diagnosis and management. Since patients with anatomic LSS can range from asymptomatic to severely disabled, the clinical diagnosis focusses on symptoms and examination findings associated with LSS. Imaging findings are helpful for patients with persistent, bothersome symptoms in whom invasive treatments are being considered. There is limited information from high-quality studies about the relative merits and demerits of commonly used treatments. Interpreting and comparing results of available research are limited by a lack of consensus about the definition of LSS. Nevertheless, evidence supports decompressive laminectomy for patients with persistent and bothersome symptoms. Recommendations favour a shared decision-making approach due to important trade-offs between alternative therapies and differences among patients in their preferences and values.

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Figures

Figure 1
Figure 1
Lumbar vertebrae. Potential regions of contact with nerve roots as described by Jenis(12): 1 central; 2 lateral recess; 3 foramen; 4 extraforaminal
See this image and copyright information in PMC

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MeSH terms