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  2. Spinal stenosis

Spinal stenosis

Definition:

Spinal stenosis is an abnormal narrowing of the spinal canal that mainly occurs in the cervical and lumbar regions. Cervical stenosis presents with axial neck pain, radiculopathy, myelopathy, or a combination of these presentations. Axial pain refers to pain that occurs along the spinal column, while radiculopathy refers to complaints in a dermatomal or myotomal distribution often occurring in the arms. Patients may complain of numbness, pain or loss of function. Myelopathy refers to a cluster of complaints and findings due to intrinsic damage to the spinal cord itself. Patients might report numbness, coordination and gait issues, grip weakness and bowel and bladder complaint. Lumbar spinal stenosis is a major cause of pain and functional disability for the elderly. Neurogenic claudication symptoms are a hallmark of lumbar spinal stenosis, where patients develop low back or leg pain when walking or standing that is relieved by sitting or lumbar flexion. The treatment of lumbar spinal stenosis generally begins with conservative management such as physical therapy, home exercise programs, and oral analgesics. Once these therapies fail, patients commonly move forward with interventional pain treatment options such as epidural steroid injections (ESIs), nerve block, or surgery as the next step. Coexisting lumbar and cervical stenosis (tandem spinal stenosis) is an infrequent presentation with mixed presentation of upper motor neuron and lower motor neuron signs. But very few reports of tandem spinal stenosis are available.

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