Information for Patients

From the American Academy of Orthopaedic Surgeons

Ask an Orthopaedic Surgeon About Spinal Stenosis

Lumbar Spinal Stenosis

by Howard S. An, MD; Dino Samartzis, BS; Ashok Biyani, MD

Lumbar spinal stenosis is a common disease process that manifests and evolves with age progression. It is one of the most frequently diagnosed conditions in adult spine patients and the most common for surgical intervention in the elderly. In essence, lumbar spinal stenosis is narrowing of the spinal canal, lateral recess, or the foramen that leads to neural compression, producing radiculopathy or neurogenic deficit. The term "stenosis" itself is derived from the Greek word stenos, which means narrow. Symptoms do vary between individuals and location of pathology. Thorough clinical evaluation must be performed and correlated to imaging studies. Conservative management is usually recommended as the first line of treatment. The extent to which a patient's activities of daily living and lifestyle are affected is particularly important in deciding on surgical treatment. Laminectomy with or without concomitant fusion can significantly improve the quality of life in carefully selected patients who have failed conservative treatment.

This OKO topic covers three surgical techniques in depth: laminectomy, spinal fusion and instrumentation, and laminoplasty. Video is available.

Keywords: spinal canal narrowing, congenital spinal stenosis, acquired spinal stenosis, foraminal stenosis, etiology, classification, anatomy of lumbar vertebrae, cauda equina compression, diagnosis, clinical presentation, patient history, physical examination, imaging, radiography, myelography, CT, MRI, electromyography, EMG, differential diagnosis, management, nonsurgical treatment, surgical treatment, surgical techniques, laminectomy, spinal fusion with instrumentation, laminoplasty, indications, contraindications, complications, outcomes, rehabilitation

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