Lumbar Spine II Flashcards
Classification of spinal stenosis
- central spinal canal
- intervertebral foreman
- subarticular or lateral recesses
What portion of the population may have asymptomatic spinal stenosis under the age of 40?
1/4
When does spinal stenosis first appear and who is it most likely to affect?
40-50 years old
men
What region is spinal stenosis most common in?
cervical and lumbar spinal regions
Where is central canal narrowing most prevalent
L4
Normal AP diameter of spinal canal adult men C3-C5:
17-18mm
Normal AP diameter of spinal canal adult men C5-C7:
12-14mm
Normal AP diameter of spinal canal adult men thoracic spine:
12-14 mm
Normal AP diameter of spinal canal adult men lumbar spine
15-27mm
What is the most serious complication of c-spine spinal stenosis?
central cord syndrome
What kind of injury is central cord syndrome associated with?
hyperextension
What is cervical spinal stenosis associated with?
Long tract and radicular signs
Headaches
Pain
Radiating electric-like shock sensations elicited with cervical spine flexion
What can concurrent cervical and lumbar spinal stenosis can present with?
Gait disturbance
Myelopathy
Radiculopathy
What does lumbar spine stenosis present with?
Diffuse unilateral or bilateral LBP and/or LE pain
Numbness
Weakness
What does lumbar extension do?
narrows canals and exacerbates symptoms
What does lumbar flexion do?
opens available space and provides some relief
Simian stance:
trunk, hip, and knee flexion
What is neurogenic claudication?
congestion of blood vessels at stenotic level
What does neurogenic claudication inhibit?
nerve conduction and results in poorly defined leg pain, numbness, and weakness
What exacerbates neurogenic claudication?
standing and spinal extension
What exacerbates vascular claudication?
exercise and improved with standing
What aggravates disk herniation?
sitting, flexion, lifting, and Valsalva maneuvers and often relieved with walking
What imaging technique is widely used for evaluation of spinal stenosis?
CT
How is mild and moderate spinal stenosis managed?
Analgesic medications
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Epidural steroid injections
PT for strengthening and flexibility exercises
