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Lumbar spinal stenosis
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Lumbar spinal stenosis

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Contributors: Phillip Mongiovi MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Lumbar spinal stenosis refers to a narrowed lumbar spinal canal. Causes include congenital forms from achondroplasia or developmental spine deformities, and acquired forms from degenerative diseases, trauma, spine surgery, Paget disease, or metabolic disorders such as osteoporosis or hypoparathyroidism. The most common of these causes are degenerative changes, including spondylolysis and spondylolisthesis.

Spinal stenosis is frequently asymptomatic but may lead to neurogenic claudication. Symptoms of neurogenic claudication include pain in the legs and/or lower back that develops with walking or standing for an extended period of time, usually relieved by leaning forward or sitting down. Pain may be associated with numbness or weakness.

When spinal stenosis is associated with neural foraminal narrowing and radiculopathy, focal weakness, sensory loss, and reflex changes may occur. Age is a risk factor for the development of lumbar spinal stenosis. Spinal stenosis is frequently incidentally found on MRI and asymptomatic.

Related topic: Cervical spinal stenosis

Codes

ICD10CM:
M48.061 – Spinal stenosis, lumbar region without neurogenic claudication

SNOMEDCT:
18347007 – Spinal stenosis of lumbar region

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Musculoskeletal back pain
  • Osteoarthritis
  • Peripheral polyneuropathy
  • Spinal dural vascular malformations
  • Vascular claudication – Activity-based pain, as opposed to posture-related pain of spinal stenosis.
  • Myopathy with proximal leg weakness

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 09/10/2018
Last Updated: 09/10/2018
Copyright © 2018 VisualDx®. All rights reserved.
Lumbar spinal stenosis
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Lumbar spinal stenosis : Gait disturbance, Leg pain, Low back pain, Muscle weakness, Numbness, Paresthesias, Buttock pain
Copyright © 2018 VisualDx®. All rights reserved.