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
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.
Lumbar Spinal Stenosis Complications
Lumbar Spinal Stenosis Follow-up Care
Lumbar Spinal Stenosis Review References