Introduction

The sequence of events leading to spinal stenosis was described in the introduction to this report. In this chapter, we further describe the natural history of lumbar stenosis by examining the evidence pertaining to questions 1-3, which were previously presented in the evidence model. Each of these questions pertains to a specific link in the evidence model.

Question 1 ("What is the relationship between each relevant patient characteristic and the presence and/or intensity of each of the patient signs, symptoms, and conditions of lumbar spinal stenosis?") examines the overarching link from patient characteristics to symptoms of stenosis. Examination of the issues pertinent to this link is complicated by the fact that many of the symptoms of stenosis are shared by other conditions, such as herniated spinal disks or vascular claudication. For this reason, this link is broken down into two shorter links. Question 2 ("Which relevant patient characteristics are associated with an increased likelihood of focal narrowing of the spinal canal?") examines the link between patient characteristics and the development of spinal stenosis. Question 3 ("What is the relationship between degree of stenosis and the presence and/or intensity of each of the signs, symptoms, and patient conditions?") examines the link between having stenosis and developing each of the signs and symptoms of the condition.
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