The team at The Poynton SpineCare Institute have created a simple guide for you and your patients to best manage their low back pain with and without leg pain.
MANAGEMENT OF LUMBAR SPINAL STENOSIS
5 per 100,000
Prevalence rate of 13% with 20%> 60 years of age
70% plateau, 15% get worse, 15% improve
Stenosis may not be symptomatic
Who is for conservative treatment?
Mild to moderate stenosis can be treated conservatively
If conservative measures fail they may require surgery
Once a Patient is referred they can be started on their individualised management plan and monitored for progression of symptoms
· Back pain +/- neurogenic claudication
· Diminished walking distance
· Changes in balance & gait
· Heaviness in legs
· Eased with forward flexion and sitting
Who is for surgery?
Generally people who have symptomatic severe stenosis
- whose quality of life and function is affected
- who have Neurology
- are not responding to conservative treatment
Age is not an exclusion for surgery as stenosis is a disease of the older population
Patients should have an individualised treatment plan consisting either of surgery or conservative intervention
· Exercise and physiotherapy
· Avoidance of extension based exercises
· Injection therapy, such as transforaminal or epidural steroid injection although evidence supporting their use is managing stenosis is low
Surgery , decompression surgery +/-instrumentation
Outcome of Surgery
Surgery has excellent long term outcome for severe spinal stenosis and can prevent progressive neurology and improve quality of life
Complications risks are low and few patients require revision surgery.
Please see www.poyntonspinecare.ie for more information on decompression surgery
How do I refer my patient to the Poynton SpineCare Insitute?
All health care professionals can refer to the Institute via email, fax, or post. If urgent referral is required please contact via telephone