Consensus criteria are needed to define and classify spinal stenosis. The means by which spinal stenosis is diagnosed is also changing. Recent concerns related to radiation risk of CT scans and the recognized limitations of spinal radiography suggest that MRI represents the best imaging modality in many cases. MRI helps to avoid myelography and the associated risk and pain. In a recent study, electrodiagnostic studies showed no superior accuracy compared with MRI. Electrodiagnostic studies, when needed, should be limited to such specific conditions as radiating leg pain.
Central spinal stenosis results from a developmental or degenerative narrow spinal canal. In certain cases, the spinal pedicles are shorter than normal. This is more common in the lumbar spine. Recognition of this primary defect in patients with short pedicles has led to pedicle-lengthening osteotomy as a treatment.
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