Lumbar Stenosis

Lumbar spinal stenosis is narrowing of the spinal canal, central or foraminal, in the lumbar spine. It is the leading cause of spine surgery in patients over 65. The narrowing results from a combination of disc degeneration, facet joint hypertrophy, and ligamentum flavum thickening — normal aging changes that accumulate over decades.

The hallmark symptom is neurogenic claudication: aching leg pain, heaviness, or numbness that comes on with walking or standing and is relieved by sitting or bending forward (the "grocery cart sign"). This distinguishes stenosis from vascular claudication, which improves with rest regardless of position.

MRI demonstrates the degree of canal and foraminal narrowing and identifies the levels responsible for symptoms. CT myelogram is used when MRI is contraindicated. ABI (ankle-brachial index) or vascular duplex may be needed to exclude peripheral arterial disease in older patients with leg symptoms. The diagnosis requires correlation of imaging with symptom pattern and walking tolerance.

1. Activity modification

   Stationary cycling (flexed posture) is well-tolerated; uphill walking is better than downhill.

Surgery helps only a small minority of spine patients — usually those with a specific structural problem plus a nerve issue that isn’t getting better with a structured non-operative trial. When that step is genuinely warranted, OSI coordinates it the same way we coordinate every other part of your care: imaging, records, and the handoff are handled for you, so no part of the process falls on your shoulders.

Emergency. Bilateral leg weakness, saddle numbness, or loss of bladder or bowel control is a surgical emergency — go to the nearest emergency department rather than waiting for a clinic appointment.

External patient-education references and related OSI pages for additional background:

• Britannica — Vertebral column
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language