Rehabilitation of orthopedic and rheumatologic disorders. 5. Lumbar spinal stenosis

Chiropractic treatment of lumbar spinal stenosis: a review of the literature

“…25 Radiographs provide health practitioners with a means to assess or visualize the bony elements of the spine. 26 Specifically, radiographs may show osteophytes (associated with disk and joint space narrowing) that can produce spinal canal and intervertebral foraminal stenosis, a decreased interpedicular diameter (which can increase the diagnostic sensitivity for intervertebral foraminal stenosis), and spondylolisthesis that can be a common predisposing lesion. 26 However, the ability to determine the degree of LSS from radiographs has not been well established; and therefore, clinical guidelines have not been formulated to aid the clinician.…”

“…26 Specifically, radiographs may show osteophytes (associated with disk and joint space narrowing) that can produce spinal canal and intervertebral foraminal stenosis, a decreased interpedicular diameter (which can increase the diagnostic sensitivity for intervertebral foraminal stenosis), and spondylolisthesis that can be a common predisposing lesion. 26 However, the ability to determine the degree of LSS from radiographs has not been well established; and therefore, clinical guidelines have not been formulated to aid the clinician. 26 It is often suggested that, for best neural foramina visualization, a sagittal magnetic resonance imaging (MRI) should be used and that both axial computed tomography (CT) and MRI images are sufficient to visualize the central canal.…”

“…26 However, the ability to determine the degree of LSS from radiographs has not been well established; and therefore, clinical guidelines have not been formulated to aid the clinician. 26 It is often suggested that, for best neural foramina visualization, a sagittal magnetic resonance imaging (MRI) should be used and that both axial computed tomography (CT) and MRI images are sufficient to visualize the central canal. Bony findings such as facet arthropathy are better visualized on CT, whereas soft tissue pathologies that can cause LSS such as a disk bulge/herniation, ligamentum flavum buckling and/or hypertrophy, and cysts of the facet capsule and ligamentum flavum are best seen on MRI.…”

Effects of Gender on Inpatient Rehabilitation Outcomes in the Elderly With Incomplete Paraplegia From Nontraumatic Spinal Cord Injury

“…Due to their shared pathophysiology (18,19) it is not unusual for patients to have more than one of these DSD pathologies. Because anatomic and symptom severity are not correlated (16), it is difficult to determine the cause of a myelopathy when multiple pathologies are present. Further, we suspected some coding errors among these etiologic diagnoses because the physicians and coders would have had varying familiarity with this population.…”

“…After identifying patients with incomplete paraplegia, we used the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes to assign patients to an etiologic group. Patients with spinal stenosis (16), spondylosis (17)(18)(19), and/or intervertebral disk disorders (20) were combined into a single etiology group (21), DSD. Spinal stenosis, spondylosis, and intervertebral disk disorders produce myelopathies, such as incomplete paraplegia, via spinal cord compression and ischemia.…”