Lumbar Spinal Stenosis

Key points

• Lumbar spinal stenosis is a condition in which the central canal is narrowed by tumour, disc prolapse, or other degenerative changes
• Patients may present with a combination of back pain, neuropathic pain, and symptoms mimicking claudication
• Symptoms are often relieved by sitting or leaning forward (flexion) and worsened by standing or walking (extension) — sometimes called the 'shopping trolley sign'
• MRI is the investigation of choice to confirm the diagnosis