Although imaging is not essential as part of an initial assessment, it is worth noting that approximately 20% of people older than 60 years old demonstrate evidence on imaging of lumbar spinal stenosis, nearly 4/5th of whom are asymptomatic. However, imaging can confirm the structural diagnosis and clarify the anatomy, especially should invasive management be contemplated. When imaging is indicated, cross-sectional imaging with magnetic resonance imaging (MRI) due to its improved ability to delineate between soft tissues (disk, muscle, cartilage, nerve root and ligament) is preferred, however if contraindicated computed tomography (CT) can be used.
