Stenosis in the Lumbar Spine: Diagnosis and Treatment

Charles D. Ray, MD, FACS, FRSH (Lond.), President, American College of Spine Surgery; President, International Spine Arthroplasty Society; Past President, North American Spine Society, Yorktown, VA, USA.

Stenoses, or nerve entrapment, can occur at several sites. The focus here is on lumbar spine segments. Compression by stenosis can exist wherever nerve tissue is protectively covered by bone or where thick ligaments are located adjacent to nerve. Overgrowth of bone by spurs is the most common cause of compression producing disability and pain. Neurologic changes are rare. Diagnostic radiological imaging is needed, sometimes aided by selective injections of medications. Due to the limitations of non-surgical treatment, surgical decompression is common with generally good results.
Key words: spinal stenosis, vertebral bone spurs, claudication, surgical decompression, nerve injections.