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Spine
Diagnosis
Degenerative Diseases and Arthritides
Degenerative Diseases
Acquired Lumbar Central Stenosis
Acquired Lumbar Central Stenosis
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Spondylosis, central canal stenosis, lumbar canal stenosis

            • Definitions

              • Spinal canal narrowing in lumbar spine
              • Secondary to multifactorial degenerative changes, being progressive, and dynamic, process

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Ruetten S et al: Endoscopic lumbar decompression. Neurosurg Clin N Am. 31(1):25-32, 2020
                                              2. Schroeder GD et al: Lumbar spinal stenosis: how is it classified? J Am Acad Orthop Surg. 24(12):843-52, 2016
                                              3. Cheung JP et al: Defining clinically relevant values for developmental spinal stenosis: a large-scale magnetic resonance imaging study. Spine (Phila Pa 1976). 39(13):1067-76, 2014
                                              4. Friedly JL et al: A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med. 371(1):11-21, 2014
                                              5. Mamisch N et al: Radiologic criteria for the diagnosis of spinal stenosis: results of a Delphi survey. Radiology. 264(1):174-9, 2012
                                              6. Andreisek G et al: Uncertainties in the diagnosis of lumbar spinal stenosis. Radiology. 261(3):681-4, 2011
                                              7. Steurer J et al: Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review. BMC Musculoskelet Disord. 12:175, 2011
                                              8. Schizas C et al: Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976). 35(21):1919-24, 2010
                                              9. Ploumis A et al: Degenerative lumbar scoliosis associated with spinal stenosis. Spine J. 7(4):428-36, 2007
                                              10. Siddiqui M et al: One-year results of X Stop interspinous implant for the treatment of lumbar spinal stenosis. Spine (Phila Pa 1976). 32(12):1345-8, 2007
                                              11. Anderson PA et al: Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine. 4(6):463-71, 2006
                                              12. Zucherman JF et al: A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976). 30(12):1351-8, 2005
                                              13. Epstein NE: Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment. J Spinal Disord Tech. 17(4):321-5, 2004
                                              14. Binder DK et al: Lumbar spinal stenosis. Semin Neurol. 22(2): 157-66, 2002
                                              15. Speciale AC et al: Observer variability in assessing lumbar spinal stenosis severity on magnetic resonance imaging and its relation to cross-sectional spinal canal area. Spine. 27(10): 1082-6, 2002
                                              16. Yukawa Y et al: A comprehensive study of patients with surgically treated lumbar spinal stenosis with neurogenic claudication. J Bone Joint Surg Am. 84-A(11): 1954-9, 2002
                                              17. Cirak B et al: Surgical therapy for lumbar spinal stenosis: evaluation of 300 cases. Neurosurg Rev. 24(2-3): 80-2, 2001
                                              18. Schonstrom N et al: Imaging lumbar spinal stenosis. Radiol Clin North Am. 39(1): 31-53, v, 2001
                                              19. Sheehan JM et al: Degenerative lumbar stenosis: the neurosurgical perspective. Clin Orthop. (384): 61-74, 2001
                                              20. Ross JS: Magnetic resonance imaging of the postoperative spine. Semin Musculoskelet Radiol. 4(3):281-91, 2000
                                              21. Jinkins JR: MR evaluation of stenosis involving the neural foramina, lateral recesses, and central canal of the lumbosacral spine. Magn Reson Imaging Clin N Am. 7(3): 493-511, viii, 1999
                                              22. Postacchini F: Surgical management of lumbar spinal stenosis. Spine. 24(10): 1043-7, 1999
                                              23. Amundsen T et al: Lumbar spinal stenosis. Clinical and radiologic features. Spine. 20(10):1178-86, 1995
                                              24. Modic MT et al: Imaging of degenerative disease of the cervical spine. Clin Orthop Relat Res. (239):109-20, 1989
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Spondylosis, central canal stenosis, lumbar canal stenosis

                                                        • Definitions

                                                          • Spinal canal narrowing in lumbar spine
                                                          • Secondary to multifactorial degenerative changes, being progressive, and dynamic, process

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Nonvascular Interventions

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Ruetten S et al: Endoscopic lumbar decompression. Neurosurg Clin N Am. 31(1):25-32, 2020
                                                                                          2. Schroeder GD et al: Lumbar spinal stenosis: how is it classified? J Am Acad Orthop Surg. 24(12):843-52, 2016
                                                                                          3. Cheung JP et al: Defining clinically relevant values for developmental spinal stenosis: a large-scale magnetic resonance imaging study. Spine (Phila Pa 1976). 39(13):1067-76, 2014
                                                                                          4. Friedly JL et al: A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med. 371(1):11-21, 2014
                                                                                          5. Mamisch N et al: Radiologic criteria for the diagnosis of spinal stenosis: results of a Delphi survey. Radiology. 264(1):174-9, 2012
                                                                                          6. Andreisek G et al: Uncertainties in the diagnosis of lumbar spinal stenosis. Radiology. 261(3):681-4, 2011
                                                                                          7. Steurer J et al: Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review. BMC Musculoskelet Disord. 12:175, 2011
                                                                                          8. Schizas C et al: Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976). 35(21):1919-24, 2010
                                                                                          9. Ploumis A et al: Degenerative lumbar scoliosis associated with spinal stenosis. Spine J. 7(4):428-36, 2007
                                                                                          10. Siddiqui M et al: One-year results of X Stop interspinous implant for the treatment of lumbar spinal stenosis. Spine (Phila Pa 1976). 32(12):1345-8, 2007
                                                                                          11. Anderson PA et al: Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine. 4(6):463-71, 2006
                                                                                          12. Zucherman JF et al: A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976). 30(12):1351-8, 2005
                                                                                          13. Epstein NE: Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment. J Spinal Disord Tech. 17(4):321-5, 2004
                                                                                          14. Binder DK et al: Lumbar spinal stenosis. Semin Neurol. 22(2): 157-66, 2002
                                                                                          15. Speciale AC et al: Observer variability in assessing lumbar spinal stenosis severity on magnetic resonance imaging and its relation to cross-sectional spinal canal area. Spine. 27(10): 1082-6, 2002
                                                                                          16. Yukawa Y et al: A comprehensive study of patients with surgically treated lumbar spinal stenosis with neurogenic claudication. J Bone Joint Surg Am. 84-A(11): 1954-9, 2002
                                                                                          17. Cirak B et al: Surgical therapy for lumbar spinal stenosis: evaluation of 300 cases. Neurosurg Rev. 24(2-3): 80-2, 2001
                                                                                          18. Schonstrom N et al: Imaging lumbar spinal stenosis. Radiol Clin North Am. 39(1): 31-53, v, 2001
                                                                                          19. Sheehan JM et al: Degenerative lumbar stenosis: the neurosurgical perspective. Clin Orthop. (384): 61-74, 2001
                                                                                          20. Ross JS: Magnetic resonance imaging of the postoperative spine. Semin Musculoskelet Radiol. 4(3):281-91, 2000
                                                                                          21. Jinkins JR: MR evaluation of stenosis involving the neural foramina, lateral recesses, and central canal of the lumbosacral spine. Magn Reson Imaging Clin N Am. 7(3): 493-511, viii, 1999
                                                                                          22. Postacchini F: Surgical management of lumbar spinal stenosis. Spine. 24(10): 1043-7, 1999
                                                                                          23. Amundsen T et al: Lumbar spinal stenosis. Clinical and radiologic features. Spine. 20(10):1178-86, 1995
                                                                                          24. Modic MT et al: Imaging of degenerative disease of the cervical spine. Clin Orthop Relat Res. (239):109-20, 1989