Spinal Stenosis

Publication Title: 
Journal of Back and Musculoskeletal Rehabilitation

BACKGROUND: Given the dearth of high quality research on conservative treatment for spinal stenosis, an empirical understanding of the scope of physical therapy provided in the community can help focus research and build standards of care. OBJECTIVES: Provide preliminary insight into current physical therapy practice in the treatment of lumbar spinal stenosis (LSS), from both patient and physical therapist perspectives. METHODS: Patients greater than 50 years of age with LSS diagnosed by a spine surgeon were recruited to participate in a telephone survey regarding treatment.

Author(s): 
Tomkins, Christy C.
Dimoff, Katherine H.
Forman, Holly S.
Gordon, Emily S.
McPhail, Jennifer
Wong, Joyce R.
Battié, Michele C.
Publication Title: 
Complementary Therapies in Medicine

OBJECTIVES: Lumbar spinal stenosis (LSS) negatively affects patients' quality of life. No systematic review evaluating the effects and safety of acupuncture for this population is available. We aimed to evaluate evidence indicating the effectiveness and safety of acupuncture for LSS. METHODS: We searched five English-language databases (EMBASE, MEDLINE, CENTRAL, CINAHL, and AMED) and one Chinese database (CAJ) for randomised controlled trials (RCTs) and non-randomised controlled clinical trials (CCTs) of needle acupuncture for LSS.

Author(s): 
Kim, Kun Hyung
Kim, Tae-Hun
Lee, Byung Ryul
Kim, Jae Kyu
Son, Dong Wuk
Lee, Sang Weon
Yang, Gi Young
Publication Title: 
Pain Medicine (Malden, Mass.)

OBJECTIVE: To present an algorithm of sequential treatment options for managing myofascial pain (MP) in older adults, along with a representative clinical case. METHODS: A modified Delphi process was used to synthesize evidence-based recommendations. A multidisciplinary expert panel developed the algorithm, which was subsequently refined through an iterative process of input from a primary care physician panel. RESULTS: We present an algorithm and supportive materials to help guide the care of older adults with MP, an important contributor to chronic low back pain (CLBP).

Author(s): 
Lisi, Anthony J.
Breuer, Paula
Gallagher, Rollin M.
Rodriguez, Eric
Rossi, Michelle I.
Schmader, Kenneth
Scholten, Joel D.
Weiner, Debra K.
Publication Title: 
Der Orthopäde

Spinal stenosis mainly is a disease of the elderly. In most cases the lumbar spine is affected. The assessment is based on the typical constellation of symptoms (neurogenic claudication, subjective weakness) and physical findings (abnormal reflex status, loss of strength, sensory deficits, impairment in balance and coordination). The diagnosis is further supported by the radiologic proof of a stenosis of the spinal canal, the lateral recess, and the intervertebral foramina.

Author(s): 
Wünschmann, B. W.
Sigl, T.
Ewert, T.
Schwarzkopf, S. R.
Stucki, G.
Publication Title: 
Journal of Back and Musculoskeletal Rehabilitation

BACKGROUND: Given the dearth of high quality research on conservative treatment for spinal stenosis, an empirical understanding of the scope of physical therapy provided in the community can help focus research and build standards of care. OBJECTIVES: Provide preliminary insight into current physical therapy practice in the treatment of lumbar spinal stenosis (LSS), from both patient and physical therapist perspectives. METHODS: Patients greater than 50 years of age with LSS diagnosed by a spine surgeon were recruited to participate in a telephone survey regarding treatment.

Author(s): 
Tomkins, Christy C.
Dimoff, Katherine H.
Forman, Holly S.
Gordon, Emily S.
McPhail, Jennifer
Wong, Joyce R.
Battié, Michele C.
Publication Title: 
Cutis

Notalgia paresthetica (NP) is a common refractory, sensory, neuropathic syndrome with the hallmark symptom of localized pruritus of the unilateral infrascapular back. It generally is a chronic noncurable condition with periodic remissions and exacerbations. While the dermatologic syndrome may be multifactorial in etiology, a possible association with underlying cervical spine disease should be evaluated for proper treatment. Collaborative multispecialty evaluation by dermatology, radiology, orthopedic surgery, and neurology may be indicated for primary management of this condition.

Author(s): 
Alai, Nili N.
Skinner, Harry B.
Nabili, Siamak T.
Jeffes, Edward
Shahrokni, Seyed
Saemi, Arash M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

The Lateral Recess Syndrome (LRS) represents stenosis of the lateral subarticular gutter that will often lead to nerve root compression. The most common etiology is hypertrophy of the superior articular facets, associated with lumbar instability and arthrosis of the posterior joint complex. The diagnosis may be made clinically with a routine lumbosacral x-ray series, but is not definitive without the use of CT scanning. Recent studies indicate that spinal manipulation can provide relief and should be considered before surgical referral is made for decompression.

Author(s): 
Ben-Eliyahu, D. J.
Rutili, M. M.
Przybysz, J. A.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Spinal stenosis is a loosely used term meaning different things to different people. A clinical picture of episodic sciatic pain and a normal physical examination usually confronts the physician. Various anatomic lesions can produce traction and compression of spinal nerve roots. The pathophysiology of the compression and the resultant ischemia of spinal nerve roots is discussed. Accurate diagnosis may allow conservative care, including manipulation, to be utilized prior to surgical consideration.

Author(s): 
Foreman, S. M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Methods to determine the sagittal diameter of spinal canal on plain film radiographs have been previously proposed by Eisenstein in 1975 and Buehler in 1978. The purpose of this study was to determine the accuracy of these methods as compared to computed tomography (CT) and to compare the accuracy of each method. The AP diameter of the lumbar canal was evaluated at the L3 through L5 levels. Results indicate that the Buehler method was significantly (p less than or equal to 0.05) more accurate than Eisenstein method at the L3 level.

Author(s): 
Dailey, E. J.
Buehler, M. T.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss the similarities and differences in the clinical presentation of Charcot-Marie-Tooth Disease, an inherited peripheral neuropathy, and acquired lumbar spinal stenosis. CLINICAL FEATURES: Patients with lumbar spinal stenosis causing nerve root entrapment often have leg pain and weakness during such activities as walking or standing. Additional symptoms of poor balance, foot deformity and signs of cerebellar and sensory ataxia suggest a diagnosis of peripheral neuropathy rather than nerve root entrapment.

Author(s): 
Martel, J.
Mierau, D.
Donat, J.

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