Eduardo Fondevila

Lumbar spinal stenosis is primarily a clinical diagnosis rather than a radiographic one. In the Wakayama Spine Study by Ishimoto et al (see illustration), only ten percent of the cohort were symptomatic despite 77.9 percent having either moderate or severe canal stenosis. pubmed.ncbi.nlm.nih.gov/2279… Terming it neurogenic claudication, in the same way that we use painful radiculopathy as a clinical presentation would make more sense. Even in the presence of radiographic changes, considerable uncertainty remains regarding whether laminectomy +/- fusion provides benefit for people with neurogenic claudication, and if so for whom, and when. These operations are lengthy and carry non trivial risk, usually in a maturing population. pubmed.ncbi.nlm.nih.gov/2682… As is usually the case, treat the (Wo)Man, not the Scan.