Lumbar Canal Stenosis: Symptoms, Diagnosis & Surgery

By Dashvanth Healthcare Medical Team · Reviewed by our specialists · East Delhi

What Is Lumbar Canal Stenosis?

Lumbar canal stenosis (LCS) is narrowing of the spinal canal in the lower back, compressing the nerve roots. It is primarily a degenerative condition of people over 50, caused by thickened ligaments, disc bulges, and bone spurs (osteophytes) encroaching on the spinal canal.

Classic Symptoms: Neurogenic Claudication

• Bilateral leg pain, heaviness, cramping, or tingling worsened by walking
• Symptoms relieved by sitting or bending forward (flexing the spine opens the canal)
• Patients can walk further pushing a trolley (flexed posture) than walking upright — the "shopping cart sign"
• Able to ride a bicycle comfortably (flexed posture)

This distinguishes neurogenic from vascular claudication — vascular leg pain is relieved by simply stopping walking (not bending).

Diagnosis

• MRI lumbar spine: shows canal diameter, nerve compression level
• CT myelogram: if MRI contraindicated
• X-ray standing (dynamic): shows instability with movement

Treatment

Conservative

• Epidural steroid injections: 50–70% short-term relief
• Physiotherapy: lumbar flexion exercises, aquatic therapy
• Walking aids (reduces forward flexion need)

Surgical

Laminectomy (decompression) removes the bone and ligament compressing the canal. Success rate: 70–80% significant improvement. If instability present, fusion is added.