Lumbar spinal stenosis is defined as reduction in the diameter of the spinal canal, lateral nerve canals or
neural foramina. The stenosis may involve multiple level of the spinal canal or may be localized or
segmental.
The natural history of spinal stenosis and degenerative spondylolisthesis is unclear because of a lack of
prospective studies following the course of patients who have been untreated. A review of the literature
shows progression of symptoms in approximately 20% of untreated patients with spinal stenosis.
Because most studies are not randomized or prospective, it is difficult to predict the natural history of the
disease and to compare the available treatment options. A slow progression may be expected to occur in
most affected patients. Even with significant canal narrowing, patients are unlikely to develop acute
cauda equine syndrome in the absence of a significant disc herniation. One study that concentrated on the
natural course of lumbar spinal stenosis reported on 32 patients who were followed for an average of 49
months (range, 10 to 103 months). The condition of 15% of these patients improved, 70% remained the
same and 15% were worse. On clinical examination, 41% were improved, 18% were worse and 41%
were unchanged. The authors concluded that severe progression was unlikely.
Lumbar spinal stenosis is defined as reduction in the diameter of the spinal canal, lateral nerve canals orneural foramina. The stenosis may involve multiple level of the spinal canal or may be localized orsegmental.The natural history of spinal stenosis and degenerative spondylolisthesis is unclear because of a lack ofprospective studies following the course of patients who have been untreated. A review of the literatureshows progression of symptoms in approximately 20% of untreated patients with spinal stenosis.Because most studies are not randomized or prospective, it is difficult to predict the natural history of thedisease and to compare the available treatment options. A slow progression may be expected to occur inmost affected patients. Even with significant canal narrowing, patients are unlikely to develop acutecauda equine syndrome in the absence of a significant disc herniation. One study that concentrated on thenatural course of lumbar spinal stenosis reported on 32 patients who were followed for an average of 49months (range, 10 to 103 months). The condition of 15% of these patients improved, 70% remained thesame and 15% were worse. On clinical examination, 41% were improved, 18% were worse and 41%were unchanged. The authors concluded that severe progression was unlikely.
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