Spinal stenosis, a cause of cauda equina compression.

In 1934 Mixter and Barr described the syndrome of the ruptured intervertebral disc in the lumbar region. Since then the herniated intervertebral disc has been considered to be the dominant cause of low back pain and sciatica. In 1953 Schlesinger and Taveras pointed out that in the presence of a narrow spinal canal patients with herniated intervertebral discs may present an atypical picture of multiple root or cauda equina compression. Verbiest in 1954 made the significant observation that structural narrowing of the spinal canal alone could, if it resulted in an incongruity between the capacity and the contents of the lumbar spinal canal, give rise to compression of the roots of the cauda equina in the absence of disc herniation. Yet, in spite of these observations, the spinal canal has received little attention. Definition-Spinal stenosis is a localised narrowing of the spinal canal due to a structural abnormality. Despite the many causes that it may have, if it gives rise to cauda equina compression, such narrowing results in a specific symptom complex, has a common pathogenesis of cauda equina compression, and demands the same treatment. It is for these reasons that we consider it prudent to regard spinal stenosis as a syndrome rather than to deal with each cause of stenosis as a separate entity.