Spinal Stenosis

Question 1

What is spinal stenosis?

Answer 1

Neurogenic claudication

Narrowing of lumbar spinal canal with compress on nerve roots

Question 2

What are the common locations of spinal stenosis?

Answer 2

L3-4
L4-5
L2-3

Question 3

What are the s/s of spinal stenosis?

Answer 3

Sudden onset vs insidious

Neurogenic claudication

• Fatigue and weakness from proximal to distal
• Sitting or lying relieves the pain

Pain relief with sitting forward

+/- low back pain

Question 4

What is observed in PE of spinal stenosis?

Answer 4

• Proprioception may be impaired= Positive Romberg test
• Segmental sensory changes
• +/- abnormal reflexes
• Normal tibial pulses
• +/- urinary or bowel symptoms, but anal sphincter tone is rarely affected

Question 5

What imaging is performed in spinal stenosis?

Answer 5

Plain films
- Up to T10

MRI

Question 6

What are the treatment options of spinal stenosis?

Answer 6

Conservative

• Pain control
• PT
• Water therapy

Surgery
- Quality of life