safety-lane.com 07105
Spinal Stenosis
Approximately 250,000-500,000 US residents have symptoms of spinal stenosis. This represents about 1 per 1000 persons older than 65 years and about 5 of every 1000 persons older than 50 years. About 70 million Americans are older than 50 years, and this number is estimated to grow by 18 million in the next decade alone, suggesting that the prevalence of spinal stenosis will increase.
Lumbar spinal stenosis remains the leading preoperative diagnosis for adults older than 65 years who undergo spine surgery. The incidence of lateral nerve entrapment is reportedly 8%-11%. Some studies implicate lateral recess stenosis as the pain generator for 60% of patients with symptomatology of failed back surgery syndrome.
Lumbar spinal stenosis remains the leading preoperative diagnosis for adults older than 65 years who undergo spine surgery. The incidence of lateral nerve entrapment is reportedly 8%-11%. Some studies implicate lateral recess stenosis as the pain generator for 60% of patients with symptomatology of failed back surgery syndrome.
For more on the epidemiology of spinal stenosis, read here
Patients with lumbar spinal stenosis usually present with a constellation of symptoms that include lower back pain, radiating leg pain (unilateral or bilateral), and possible bladder and bowel difficulties. The classic presentation is radiating leg pain (with or without a numbness and tingling sensation) associated with walking that is relieved by rest (neurogenic claudication). When patients bend forward, the pain diminishes. Rarely, patients with lumbar spinal stenosis present with cauda equina syndrome (bilateral leg weakness, urinary retention due to atonic bladder).
MRI is the imaging modality of choice for lumbar spinal stenosis. CT scanning provides excellent central canal, lateral recess, and neuroforaminal visualization. In regard to nuclear imaging, medical diseases related to the bones of the vertebral bodies present with markedly increased nuclide uptake. Angiography is rarely indicated except in patients with arteriovenous malformations, dural fistulas, and vascular spinal tumors. Needle electromyography can help to diagnose lumbosacral radiculopathy with axonal loss. Nerve conduction studies can help to differentiate lumbar spinal stenosis from other confounding neuropathic conditions (eg, lumbosacral plexopathy, generalized peripheral neuropathy, tarsal tunnel syndrome, other mononeuropathies).
via Blogger http://bit.ly/1trKv5p
Recent Comments