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Pain in the low back, buttock, and/or lower extremity (pain NRS > 4) with standing, walking and/or spinal extension (buttock/leg > back pain)
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Cognitive impairment that renders the patient unable to give informed consent or provide accurate data.
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Roland-Morris score of at least 7
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Fibromyalgia diagnosis, chronic widespread pain, lower extremity amputation, Parkinson's, head injury, stroke, other neurologic conditions.
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Mild-moderate-severe lumbar central canal spinal stenosis identified by MRI or CT according to the criteria of Boden et al. [12]
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Severe vascular, pulmonary or coronary artery disease that limits ambulation including recent myocardial infarction (within the last 6 months).
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Lower extremity symptoms consistent with neurogenic claudication
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Spinal instability requiring surgery.
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Must be able to read English and complete the assessment instruments
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Severe osteoporosis as defined by multiple compression fractures or a fracture at the same level as the stenosis.
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Age 50 or older
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Metastatic cancer.
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Excessive alcohol consumption or evidence of non-prescribed or illegal drug use as determined by the TICS screening questionnaire (1 or more positive answer).
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Possible pregnancy or other condition that precludes the use of fluoroscopy.
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Concordant pain with internal rotation of the hip (or known hip joint pathology).
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Active local or systemic infection.
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Allergy to local anesthetic, steroid or contrast.
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