Lumbar Canal Stenosis

Question 1

How does lumbar canal stenosis often present?

Answer 1

Neurogenic claudication

Question 2

Neurogenic vs vascular claudication

Answer 2

Vascular:
* Distal to proximal cramping
* Fixed distance which elicits symptoms
* Stand still to relieve
* Relieved in seconds

Neurogenic:
* Variable distance
* Sit to relieve symptoms (+/- leaning forwards)
* Relieved in minutes
* Associated with pins and needles, numbness and weakness

Question 3

Examination findings for lumbar canal stenosis

Answer 3

• Present pulses
• Exacerbated symptoms by lumbar extension
• Relieved by sitting
• Reduced reflexes
• Reduced lumbar lordosis
• +ve SLR

Question 4

Clinical tests for LCS

Answer 4

• SLR
• MRI scan
• Can do ankle-brachial pressure index to differentiate if vascular involvement

Question 5

Management for LCS

*

Answer 5

• Exercise
• Weight loss if indicated
• Analgesia
• Physiotherapy
• Decompression surgery if none of those work - laminectomy