A maladaptive gait abnormality in patients with lumbar spinal stenosis

A maladaptive pattern of abnormally increased anterior pelvic tilt during gait was documented using quantitative gait analysis in two patients presenting with lumbar spinal stenosis. Both patients also had, by physical examination, mild bilateral hip flexion contracture impairments which mayor may not have been directly related to the spinal stenosis. There is no literature to date supporting the presence of either hip flexion contractures or excessive anterior pelvic tilt during gait in patients with lumbar spinal stenosis. The excessive anterior pelvic tilt present in these patients was presumably a compensation for the hip flexion contractures to achieve reasonable step lengths. Increased anterior pelvic tilt induces increased hyperextension of the lumbosacral spine, which in a patient with spinal stenosis, could cause pain and lead to further spinal nerve impingement. Since hip flexion contracture impairments are amenable to stretching, their presence should be especially pursued in patients with spinal stenosis.