Lumbar Spinal Stenosis

Lumbar spinal stenosis, the most common spinal disorder in the elderly, consists of clinical signs and symptoms, which result from narrowing of the spinal canal.

Pathophysiology

Lumbar spinal canal narrowing results from degenerative thickened facets, hypertrophy of the ligamentum flavum, bulging discs, or degenerative spondylolisthesis (Figure 4-2). It has been shown that the hypertrophied ligamentum flavum loses its elastic fibers and may become calcified or, at times, ossified. Reduced elasticity may lead to bulging of the ligamenta flava into the spinal canal even in the standing position.

Clinical Presentation

Lumbar spinal stenosis often presents with low back and bilateral lower extremity pain. Walking brings about pain in the buttocks, thighs, or legs—neurogenic claudication. The pain may become severe

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