Lumbar Spinal Stenosis

Presentation

• “Pseudo-claudication” pain in the back or legs with walking
• Improves with rest or lumbar flexion

Signs and Symptoms

• Neurogenic claudication
• Bilateral buttock/leg pain
• Symptoms improve with lumbar flexion and worsen with walking
  
• Relief with sitting
• Wide based gait
• Abnormal Romberg

Treatment

• Non-operative – 50-70% remain symptomatic
  
• Pharm:
  • acetaminophen -> NSAIDS-> gabapentin
    
• Lumbar epidural injections w/ steroids
  
• Lumbosacral corset
  • can increase walking distance and decrease pain