The clinical presentation of lumbar spinal stenosis

A retrospective review of 49 patients hospitalized with newly diagnosed lumbar spinal stenosis describes the presentation of this unusual cause of back pain. The pain distribution was bilateral in half of the cases and neurogenic claudication, thought to be diagnostic, was reported in only 20% of cases. Multiple levels of stenosis were identified in the majority of patients, with L 4/5 being the most common site, and stenosis co-existed with lumbar disc disease in one-third of patients. The diverse presentation and lack of a screening clinical marker make spinal stenosis difficult to recognize clinically in patients presenting with low-back pain.