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Nonsurgical and Surgical Management of Lumbar Spinal Stenosis

Nonsurgical and Surgical Management of Lumbar Spinal Stenosis <h2>Introduction</h2> The pain and disability associated with lumbar spinal stenosis can interfere with patients' lifestyles, leading them to seek medical attention. Typical symptoms of spinal stenosis (neurogenic claudication) include pain, numbness, and paresthesias in the posterolateral aspects of the thighs and legs. These symptoms usually radiate distally and are aggravated by prolonged walking or standing. Activities in which the lumbar spine is in flexion, such as walking uphill, leaning forward on a walker or shopping cart, or riding a bicycle, are usually better tolerated by patients with neurogenic claudication. It is crucial to distinguish between neurogenic and vascular claudication when establishing the diagnosis of spinal stenosis 1 . Claudication of vascular etiology is usually associated with calf pain, which may extend proximally. In peripheral vascular disease, lower-extremity pulses are diminished and the symptoms are aggravated by activity in any position and are relieved by rest in any position. Only after a clear diagnosis of neurogenic claudication has been made and a vascular etiology has been ruled out should treatment of spinal stenosis commence. Treatment options for lowback pain and neurogenic claudication related to lumbar spinal stenosis include nonoperative modalities, surgical decompression alone, or surgical decompression and fusion with http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Bone and Joint Surgery Wolters Kluwer Health

Nonsurgical and Surgical Management of Lumbar Spinal Stenosis

Journal of Bone and Joint Surgery , Volume 86 (10): 2319 – Oct 1, 2004
12 pages

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2004 by The Journal of Bone and Joint Surgery, Inc.
ISSN
0021-9355
Publisher site
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Abstract

<h2>Introduction</h2> The pain and disability associated with lumbar spinal stenosis can interfere with patients' lifestyles, leading them to seek medical attention. Typical symptoms of spinal stenosis (neurogenic claudication) include pain, numbness, and paresthesias in the posterolateral aspects of the thighs and legs. These symptoms usually radiate distally and are aggravated by prolonged walking or standing. Activities in which the lumbar spine is in flexion, such as walking uphill, leaning forward on a walker or shopping cart, or riding a bicycle, are usually better tolerated by patients with neurogenic claudication. It is crucial to distinguish between neurogenic and vascular claudication when establishing the diagnosis of spinal stenosis 1 . Claudication of vascular etiology is usually associated with calf pain, which may extend proximally. In peripheral vascular disease, lower-extremity pulses are diminished and the symptoms are aggravated by activity in any position and are relieved by rest in any position. Only after a clear diagnosis of neurogenic claudication has been made and a vascular etiology has been ruled out should treatment of spinal stenosis commence. Treatment options for lowback pain and neurogenic claudication related to lumbar spinal stenosis include nonoperative modalities, surgical decompression alone, or surgical decompression and fusion with

Journal

Journal of Bone and Joint SurgeryWolters Kluwer Health

Published: Oct 1, 2004

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