A 55 year-old woman complained of pain in the back, buttocks and thighs after walking for 2 blocks. The pain was relieved with sitting, but not standing.

T2-weighted MRI of the Lumbar Spine. (Left) Mid-sagittal view; (Right) Axial scan at different levels corresponding to the labels on the sagittal scan. Note at levels B and D which correspond to the L3-4 and L4-5 levels, there is moderate stenosis. The thecal sac has taken a triangular shape and CSF signal (white) is completely attenuated.Lumbar spinal stenosis frequently presents with so-called "neurogenic claudication," where the patient notes back and radicular pain with prolonged standing and walking. Compared to vascular claudication, neurogenic claudication is only relieved by the sitting position, whereas symptoms from vascular claudication improve if the patient rests either in the standing or sitting position. Spondylosis is a degenerative condition caused by the combination of disk disease, ligament hypertrophy and facet/bony hypertrophy.

Revised 04/30/06.
The Electronic Curriculum is copyrighted 1998,  Case Western Reserve University School of Medicine.