The imaging of lumbar spinal stenosis

Lumbar spinal stenosis (LSS) is a relatively common condition of varied aet iology which results in chronic compression of the cauda equina, It becomes clinically relevant when giving rise to symptoms of neurogenic claudicatio n or leg pain. Lumbar spinal stenosis can be classified based on anatomy or aetiology and the diagnosis In any single case should include a considerat ion of both the site and the cause. Plain radiography is of limited value. Myelography with erect lateral flexion/extension views will demonstrate the dynamic component of the stenosis which cannot be appreciated on plain com puted tomography (CT) or magnetic resonance imaging (MRI). Therefore, in pa tients with a good history of symptomatic LSS, and a borderline stenosis on MRI, CT myelography is recommended as the definitive pre-operative imaging investigation. (C) 2000 The Royal College of Radiologists.