To the Editor: In their Commentary on lumbar spinal stenosis, Drs Haig and Tomkins1 insisted on the diagnostic importance of finding and treating “what is not stenosis,” which includes peripheral artery disease (PAD). This is important not only because ischemia of the nerve roots resulting from compression by adjacent structures has been proposed as a mechanism of pain in lumbar spine stenosis,2 but also because lumbar spinal stenosis and PAD share the risk factors of aging and obesity.
Abraham P, Ouedraogo N, Leftheriotis G. Diagnosing Lumbar Spinal Stenosis. JAMA. 2010;303(15):1479-1481. doi:10.1001/jama.2010.439