Table 1 Lumbar spinal stenosis clinical phenotype descriptions

TYPE A:

NEUROGENIC CLAUDICATION PAIN SYMPTOMS

Neurogenic claudication describes the typical widespread lower extremity pain aggravated during walking in people with LSS. Symptoms of aching, cramping, pain or burning most commonly affect both legs, though not always symmetrically. The symptoms are precipitated by standing as well as walking and relieved with sitting/ forward flexion/ lying down. These dynamic, posture-related bilateral pain symptoms are generally considered to be associated with central canal stenosis in the lumbar spine

TYPE B:

NEUROGENIC CLAUDICANT SENSORY/ BALANCE SYMPTOMS

Neuroischaemic symptoms associated with LSS include tingling, paraesthesia, numbness and weakness in the lower extremities, usually bilaterally, and can also include problems with balance. As with other LSS phenotypes, these neuroischaemic symptoms are precipitated by standing and walking. The symptoms are generally considered to be due to central canal stenosis in the lumbar spine causing intermittent compromise of the cauda equina/ nerve roots related to compression, venous stasis and hypoxia

TYPE C:

RADICULAR UNILATERAL LEG PAIN SYMPTOMS

Radicular-type leg pain symptoms affecting predominantly one lower extremity are generally considered to be due to direct nerve root compromise associated with lateral recess canal stenosis or foraminal stenosis in the lumbar spine. These symptoms generally follow a specific dermatomal pattern. Symptoms are aggravated by standing and walking but may also be present at other times. Since there may be inflammation of the nerve root, symptoms are less influenced by change in posture, and can also be experienced at rest, when sitting or at night in bed