Spinal stenosis is a loosely used term meaning different things to different people. A clinical picture of episodic sciatic pain and a normal physical examination usually confronts the physician. Various anatomic lesions can produce traction and compression of spinal nerve roots. The pathophysiology of the compression and the resultant ischemia of spinal nerve roots is discussed. Accurate diagnosis may allow conservative care, including manipulation, to be utilized prior to surgical consideration.
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