Introduction to symptomatic spinal canal stenosis

Spinal canal stenosis is the narrowing of the vertebral or intervertebral canal and is often multifactorial. The lower 3 lumbar levels are most frequently affected. Spinal canal stenosis can be asymptomatic and is detected on imaging in over 20% of people older than 60 years of age without a history of back pain.

The clinical course of symptomatic spinal canal stenosis is variable, and can be unpredictable, with flares and stable periods over time. Approximately 50% of patients remain clinically stable, while 25% deteriorate over time and the remaining 25% improve over time. Despite the common perception of a progressive course, patients with mild to moderate symptomatic spinal canal stenosis have a favourable outcome in 30 to 50% of cases.

For advice on assessing a person who presents with back pain, see Assessment of back and neck pain.