A 62 year-old man complained of pain in the back, buttocks and thighs after walking two blocks. The pain was relieved with sitting, but not standing.

T2-weighted MRI of the Lumbar Spine. (Left) Mid-sagittal view; (Right Top) Axial scan at the mid-L3 level; (Right Bottom) Axial scan at the L3-L4 disk level. Note the stenosis at the L3-L4 level. Contrast the two axial scans - the upper scan clearly visualizes the nerve roots of the cauda equina within the thecal sac, whereas in the lower scan, no CSF is seen and the nerve roots are clearly compressed.  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.
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