Skip to Main Content

++

  • 723.0 Spinal stenosis in cervical region
  • 724.0 Spinal stenosis other than cervical
  • 724.00 Spinal stenosis of unspecified region
  • 724.01 Spinal stenosis–thoracic
  • 724.02 Spinal stenosis, lumbar region, without neurogenic claudication
  • 724.03 Spinal stenosis, lumbar region, with neurogenic claudication
  • 724.09 Spinal stenosis of other region

++

  • M48.00 Spinal stenosis, site unspecified
  • M48.02 Spinal Stenosis, cervical region
  • M48.04 Spinal stenosis, thoracic region
  • M48.06 Spinal stenosis, lumbar region
  • M48.08 Spinal stenosis, sacral and sacrococcygeal region

++
++

Description

++

  • Common degenerative spinal condition
  • Associated with narrowing of the spinal canal (central stenosis) or foraminal canals (lateral stenosis)
  • Caused by degenerative changes in intervertebral discs and facet joints
  • Can result in spinal cord compression, cauda equina compression, or nerve root compression

++

Essentials of Diagnosis

++

  • Can result in neurogenic claudication, with pain, cramping, and paresthesias in the limbs aggravated by walking and relieved by sitting/flexion
  • Diagnosis made by clinical examination
  • Differentiation between vascular and neurologic claudication
  • Reproduction of symptoms in specific postures and activities

++

General Considerations

++

  • Cervical spinal stenosis can result in spinal cord compression and resulting upper motor neuron signs
  • Cervical central stenosis can give both upper and lower extremity symptoms

++

Demographics

++

  • Prevalence increases with age
  • Primarily occurs over 65 years of age

++

Signs and Symptoms

++

  • Unilateral or bilateral leg pain with lumbar stenosis
  • Unilateral or bilateral upper limb pain and myelopathy with cervical stenosis
  • Pain worse with walking, relieved by sitting
  • Can be with or without low back pain (LBP) or neck pain
  • Altered sensation, motor control and reflexes in the distribution of the involved nerve roots
  • Increased symptoms with extension
  • Relief with sitting (lumbar flexion) with lumbar stenosis

++

Functional Implications

++

  • Difficulty with walking longer distances
  • Difficulty with standing activities
  • Possible bowel/bladder dysfunction with cervical stenosis

++

Possible Contributing Causes

++

  • Postural changes
  • Weakness of core musculature
  • Tightness of hip flexors, external rotators, and hamstrings

++

Differential Diagnosis

++

  • Vascular insufficiency
  • Peripheral nerve impairment
  • Hip pathology with radiating pain pattern
  • Osteoarthritis
  • Spinal tumor
  • Peripheral neuropathy
  • Degenerative Disk disease

++

Imaging

++

  • MRI helpful in diagnosis to visualize compressed or inflamed nerve root
  • X-ray/plain film radiograph helpful if osteophyte located in intervertebral foramen
  • CT scan to show herniation compressing the spinal canal/nerves
  • Electrodiagnostic/nerve conduction testing can assist to determine a specific impaired nerve function
  • Doppler ultrasound to examine vascular function

++

  • Physical Examination
    • Algorithm for examination of the lumbar spine
    • Two-stage treadmill test
    • Ankle-brachial index (ABI) to screen for peripheral arterial disease (PAD)
    • Quadrant test
    • Straight leg raise test
    • Crossed straight leg raise test
    • Slump test
    • Lower limb nerve ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.