Week 3 - Spinal Stenosis and Claudication

Question 1

what is spinal stenosis?

Answer 1

compression or irritation of multiple nerve roots in the cauda equina

Question 2

what causes spinal stenosis?

Answer 2

spondylosis
bulging discs
bulging ligamentum flavum
osteophytosis

Question 3

who does spinal stenosis typically occur in and how does it present?

Answer 3

tends to affect over 60s

presents with claudication (pain in legs on walking)

Question 4

how does claudication from spinal stenosis differ to vascular claudication?

Answer 4

distance at which claudication occurs is inconsistent
pain is burning rather than cramping
pain is less when walking uphill
pedal pulses are preserved

Question 5

why is pain less when walking uphill?

Answer 5

spin flexion creates more space for the cauda equina

Question 6

what is 1st line treatment for spinal stenosis?

Answer 6

conservative - physio, weight loss etc

Question 7

when would decompression surgery be indicated for spinal stenosis?

Answer 7

if symptoms don’t improve with conservative management

MRI evidence of stenosis