The assessment and management of a patient presenting with symptomatic lumbar degenerative stenosis poses a series of problems linked to the variable clinical presentation and the frequent coexistence of other conditions in a typically aged population. Other factors causing difficulty are the lack of standardized diagnostic criteria, and the fact that spinal stenosis is frequently detected on bio-imaging in subjects who are completely asymptomatic. For this reason, the patient’s medical history, physical examination and radiological images need to be carefully analyzed and weighed up in relation to each other in order to obtain a complete picture of the clinical situation, propose an appropriate therapeutic strategy and monitor the evolution of the disease.
This article presents and discusses the process of clinical assessment and diagnosis involved in the care of a patient with symptomatic lumbar degenerative stenosis.