Overview
The nerves of the lumbar spine pass through a tunnel called the spinal canal before exiting the spine and traveling towards the legs. Lumbar spinal stenosis occurs when the spinal canal becomes narrowed, putting pressure on the nerves passing through. This often results in back pain going into the legs, tingling and numbness which worsens with standing and walking and improves with sitting and leaning forward. This is generally a gradually worsening condition, and patients may find the length of time they can stand or walk slowly decrease overtime.
Diagnosis
A diagnosis of lumbar spinal stenosis is first suspected based on a careful history and physical exam. Ultimately, MRI is the gold standard study for diagnosis spinal stenosis. A CT scan may also be used but is less sensitive than MRI.
Treatment
In most cases, initial treatment consists of physical therapy, medications, activity modification, assistive devices for walking, and injections. For more severe cases of spinal stenosis or symptoms which are not well managed through conservative measures, surgical intervention may be indicated (see Minimally Invasive Laminectomy).