الفهرس 
introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
The study reviewed the anatomy of the bony and soft tissue components of the lumbar spinal canal as well as its neural contents. The pathological changes involved in stenosis of the lumbar canal had been discussed. The clinical features of the disease are often subjective, vague, ill-described and lack substantiation on examination; therefore the history, rather than the objective findings, is the clue to reach the proper diagnosis. Symptoms, such as leg pain, weakness and parasthesia, may be continuous or intermittent. Intermittent symptoms are precipitated by walking and prolonged standing. Physical signs may include positive back signs, motor and sensory deficits, reflex changes and positive stretch signs. In many instances, the clinical examination may be completely normal. Radiological investigations include plain X-ray, CT and MRI. Plain X¬ray is valuable to exclude any other pathology or bone disease in addition to evaluation of stability. CT and MRI are the best non invasive procedure to detect the site and nature of stenosis whether bony or soft tissue. CT is more valuable in assessment of bony components of the lumbar canal, while MRI is more valuable in evaluation the soft tissue components of the canal. Failure to respond to conservative treatment necessitates surgical decompression. The decompression should be as limited as possible to avoid post-operative iatrogenic stenosis and instability. The extent of decompression should be guided by the clinical features, the radiological studies and the operative findings.