Spinal Stenosis Flashcards
What happens in spinal stenosis?
Narrowing of the spinal canal leading to compression of the spinal cord or nerve roots
What are the typical sites of spinal stenosis?
Lumbar (most common)
Cervical
When is spinal stenosis more likely to occur?
Patients over 60 relating to degenerative changes in the spine
What are the three types of spinal stenosis?
Central
Narrowing of the central spinal canal
Lateral
Narrowing of the nerve root canals
Foramina stenosis
Narrowing of the intervertebral foramina
What conditions can cause the spinal canal to narrow?
Congenital spinal stenosis
Degenerative changes
Herniated discs
Thickening of ligamentium flavum or posterior longitudinal ligament
Spinal fractures
Spondylolisthesis
Tumours
How does spinal stenosis present?
Gradual onset
Depends on severity of narrowing
What is pseudoclaudication?
Feature of lumbar spinal stenosis with central stenosis, symptoms of:
-Lower back pain
-Buttock and leg pain
-Leg weakness
When do you get symptoms of spinal stenosis?
Standing and walking
Why does bending forward relieve symptoms of spinal stenosis?
Expands the spinal canal reducing compression improving symptoms
Standing straight extends the spine causing increased narrowing
What kind of symptoms do lateral and foramina stenosis cause?
Sciatica-like symptoms
What does radiculopathy mean?
Compression of the nerve roots as they exit the spinal cord and column causing motor and sensory symptoms
What is the primary imaging investigation for spinal stenosis?
MRI
Use ABPI to exclude peripheral arterial disease
How is spinal stenosis managed?
Exercise and weight loss
Analgesia
Physiotherapy
Decompression surgery
What is a laminectomy?
Removal of part or all of the lamina from affected vertebra
