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Lumbar Spinal Stenosis M48.06 724.2

 

synonyms:

Lumbar Spinal Stenosis ICD-10

Lumbar Spinal Stenosis ICD-9

  • 724.02 (Spinal Stenosis; lumbar region)

Lumbar Spinal Stenosis Etiology / Epidemiology / Natural History

  • Etiology: mechanical compression, local irritation from increased neural tension and local ischemia
  • Natural History: Variable. Most do not have severe neuroligc deficits or impairment. Paralysis iin uncommon. Long term follow-up of patients treated non-operatively show lightl improvement or unchanged.

Lumbar Spinal Stenosis Anatomy

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Lumbar Spinal Stenosis Clinical Evaluation

  • Buttock and leg pain
  • Exacerbated by lumgar extension and ambulation
  • Relieved by lumbar flexion, rest
  • Less pain walking uphill than downhill.
  • Forward flexion improves pain.
  • Typically 40's to 80's

Lumbar Spinal Stenosis Xray / Diagnositc Tests

  • A/P, lateral, flexion/extension views. Evaluate for: lumbar degeneration, congential stenosis, scoliosis, spondylolisthesis, infection, malignanacy.
  • MRI: best demonstrates amount and location of stenosis.
  • EMG/NCV: may aid in differentiating spinal stenosis and discogenic low back pain.

Lumbar Spinal Stenosis Classification / Treatment

  • Nonop: activity modification, NSAIDs, PT, ESI/SNRI.
  • Decmpressive laminectomy

Lumbar Spinal Stenosis Associated Injuries / Differential Diagnosis

  • Vascular Claudication: typically worse with exercise and improves with sitting. Decreased peripheral pulses.
  • Degenerative disc disease
  • Tandem Spinal Stenosis: combined cervical and lumbar stenosis. @15% of patients.
  • Spondylolysis

Lumbar Spinal Stenosis Complications

  • Instability

Lumbar Spinal Stenosis Follow-up Care

Lumbar Spinal Stenosis Review References

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