Spinal Stenosis

N. Wilson Holland, MD, FACP, AGSF and Birju B. Patel, MD, FACP, AGSF Reviewed 06/2018
 


BASICS

DESCRIPTION

Narrowing of the spinal canal and foramen: 
  • Spondylosis or degenerative arthritis is the most common cause of spinal stenosis, resulting from compression of the spinal cord by disc de...

DIAGNOSIS

HISTORY

  • Helps distinguish spinal stenosis from other causes of back pain and peripheral vascular disease.

    • Insidious onset and slow progression are typical; discomfort with standing, paresthe...

TREATMENT

  • In general, nonoperative interventions are preferred in the absence of progressive or debilitating neurologic symptoms:

    • Physical therapy, exercise, weight management, medications, and epidu...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Follow up based on progression of symptoms.

  • No limitations to activity; patients may be as active as tolerated. Exercise should be encouraged.

Patient Monitoring

Pat...

REFERENCES

1 Suri P, Rainville J, Kalichman L, et al. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA.  2010;304(23):2628–2636.  [View...

SEE ALSO

Algorithm: Low Back Pain, Acute 

CODES

ICD10

  • M48.00 Spinal stenosis, site unspecified

  • M48.06 Spinal stenosis, lumbar region

  • M48.04 Spinal stenosis, thoracic region

  • M48.05 Spinal stenosis, thoracolumbar region

  • M48.08 Spinal stenosis, sacra...

CLINICAL PEARLS

  • Spinal stenosis typically presents as neurogenic claudication (pain, tightness, numbness, and subjective weakness of lower extremities), which can mimic vascular claudication.

  • Flexion o...

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