Materiały źródłowe

• #1 Diagnosing Lumbar Spinal Stenosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1115/p1145.html

  What is the best way to diagnose lumbar spinal stenosis in patients with leg pain or numbness? […] Lumbar spinal stenosis is an important cause of pain and disability, and surgery is beneficial for appropriately selected patients. Therefore, it is important for primary care physicians to distinguish patients with spinal stenosis from those with musculoskeletal low back pain, peripheral vascular disease, or spinal disk disease. […] Individual signs and symptoms suggestive of lumbar spinal stenosis include older age at onset, longer duration of symptoms, symptoms that worsen with walking or standing, numbness of the lower legs with activity, symptoms that improve with bending forward, and symptoms that worsen with bending backward. The findings that most strongly suggest lumbar spinal stenosis are symptoms that improve with bending forward, urinary disturbance, and intermittent claudication.

• #1 Spinal Stenosis Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-stenosis

  Spinal stenosis is a narrowing of the spinal canal, the bony structure that encloses the spinal cord and the nerve roots. […] The diagnosis of spinal stenosis begins with a complete history and physical examination. The doctor will determine what symptoms exist, what makes them better or worse, and how long they have been present. A neurological examination that demonstrates abnormalities in the strength, sensation and reflexes of particular parts of the body may provide objective evidence of spinal cord or nerve root compression caused by spinal stenosis. […] In addition to taking a history and conducting a physical examination, the doctor may order the following exams to help diagnose spinal stenosis: X-ray (also known as plain films): test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones.

• #1 Spinal Stenosis: Diagnosis & Test | Management & Treatment: Pain Care, LLC: Interventional Spine & Pain Management

  https://www.georgiapaincare.com/blog/spinal-stenosis-diagnosis-test-management-treatment

  How is spinal stenosis diagnosed? Your provider at Pain Care will review your medical history, ask about your symptoms and conduct a physical exam. During your physical exam, your healthcare provider may feel your spine, pressing on different area to see if this causes pain. Your provider will likely ask you to bend in different directions to see if different spine positions bring on pain or other symptoms. Your provider will check your balance, watch how you move and walk and check your arm and leg strength. […] Your provider will order imaging test or review current imaging tests to examine your spine and determine the exact location, type and extent of the problem. Imaging studies may include: […] X-rays: X-rays use a small amount of radiation and can show changes in bone structure, such as loss of disk height and development of bone spurs that are narrowing the space in the spine.

• #1 Spinal Stenosis Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/344171-overview

  Spinal stenosis rates and the money spent to treat spinal stenosis and back pain have increased. In addition to the generally increasing age of the population, many theories have been offered regarding the increased occurrence, with obesity being considered as the most likely factor. […] The goal of spinal imaging is to localize the site and level of disease and to help differentiate between conditions in which patients require surgery and conditions in which patients recover following conservative treatment. It is important to correlate imaging findings with the signs and symptoms of the spinal disease under consideration. […] Spinal stenosis is best diagnosed using MRI. In the lumbar spine, MRI sequences may include sagittal T1-weighted, T2-weighted, STIR, and proton density-weighted, as well as axial T1-weighted and T2-weighted sequences.

• #1 Spinal Stenosis Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-stenosis

  Magnetic resonance (MR) imaging: provides detailed images of soft tissues like the spinal cord and nerve roots. As a result, MRIs are very helpful in determining the location and severity of the stenosis and in identifying spinal cord or nerve root compression. […] Computed tomography scan (CT scan): this scan uses X-rays and a computer to provide images that are more detailed than general X-rays. […] Myelogram: X-rays and CT scans taken after a dye is injected into the spinal canal. This test is useful in patients who have had previous surgery or who have another condition, such as scoliosis.

• #1 Spinal stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Spinal_stenosis

  In CT myelography, spinal tap is performed in the low back with dye injected into the spinal fluid. X-rays are performed followed by a CT scan of the spine to help see narrowing of the spinal canal. This is a very effective study in cases of lateral recess stenosis. It is also necessary for patients in which MRI is contraindicated, such as those with implanted pacemakers.

• #1 Spinal stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/diagnosis-treatment/drc-20352966

  Your healthcare professional may ask about your symptoms and medical history. You may have a physical exam. You also may need an imaging test to help find the problem. […] These tests may include: […] An X-ray of the back can show bone changes that may be making the space within the spinal canal smaller. […] An MRI uses a powerful magnet and radio waves to produce detailed images of hard and soft tissue. The test can detect damage to the disks and ligaments. It also can show whether tumors are present. […] If you can’t have an MRI, you may need a CT scan. This test combines X-ray images taken from many different angles. In a CT myelogram, a contrast dye is injected to outline the spinal cord and nerves. This can show herniated disks, bone spurs and tumors. […] Treatment for spinal stenosis depends on how severe your symptoms are.

• #1

  https://www.advocatehealth.com/health-services/brain-spine-institute/spine-care-center/spinal-stenosis

  Diagnosis of spinal stenosis begins with performing a thorough evaluation. We’ll ask you about your stenosis symptoms and medical history. You’ll be asked about the exact location of the pain and whether it also travels down the arms, back or legs. We’ll ask you to describe how the pain feels (e.g., aching, burning or tingling), tell us about how long you’ve been having the pain and about anything you’ve done to treat your pain. […] Some of the tests we perform may include: […] Imaging scans: CT scans or MRI scans detect damage in your spinal canal. Another test we may use is a myelogram, where we inject a dye into your spine to make it easier to see the test results. X-rays can also help rule out other injuries that may be causing your symptoms. […] Electromyography (EMG): Stenosis sometimes puts pressure on the nerves in the back, damaging or irritating them. This test measures the electrical activity of your muscles to identify nerve damage or irritation. […] Bone scan: These scans help rule out other causes of your pain, such as tumors, fractures or arthritis.

• #1 Spinal stenosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/191/?locale=es_ES

  Spinal stenosis is a condition typically resulting from degenerative changes in the lumbar spine. […] Lumbosacral spine x-rays and computed tomography scans show degenerative changes and possibly spondylolisthesis, but magnetic resonance imaging is the best technique to show neural element compression in the spinal canal and foramina. […] Neurological deficit including sensory or motor loss occurs in up to 30% of patients, and patients may experience severe morbidity from reduction in the ability to walk. […] Key diagnostic factors include presence of risk factors, onset and duration of symptoms, back pain, activity-related back pain, leg pain when walking, stooped posture when walking, leg numbness or paraesthesiae, and absence of examination findings. […] 1st investigations to order include plain x-ray and MRI (T2-weighted). […] Investigations to consider include CT myelography, CT spine, electromyographic (EMG) walking test, and electromyographic paraspinal mapping.

• #1 Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment – Wu – AME Medical Journal

  https://amj.amegroups.org/article/view/3837/html

  Lumbar spinal stenosis (LSS) is a common spinal disorder in the older population, and the clinical syndrome consisting of pain in the buttock or lower extremity, with or without low back pain and corresponding imaging findings of narrowing of spaces around neural and vascular elements in the lumbar spine. The diagnosis depends on history, symptoms, physical examination, radiographies. […] MRI is commonly used to confirm the LSS. The MRI, which has excellence in observation for soft tissue, is recommended to diagnose LSS by many authors. […] No gold standard diagnostic criterion is widely accepted among physicians. Therefore, to diagnose LSS, we need comprehensive consideration of the history, physical examination, and radiographic images. Most often information including age, neurogenic claudication, the radiating buttock or leg pain which is exacerbated when lumbar extension and relieved at seat or lumbar flexion, wide based gait, and the anatomic narrow observed at radiographic images, sometimes even the results of electromyography and nerve root block is used.

• #1 Lumbar Spinal Stenosis | Diagnosis & Treatment for Physios

  https://www.physiotutors.com/conditions/lumbar-spinal-stenosis/

  Cook et al. (2019) conducted a systematic review of the diagnostic accuracy of patient history, clinical findings, and physical tests in the diagnosis of lumbar spinal stenosis. They found 3 physical tests to be useful in the diagnosis of LSS. […] Genevay et al. (2018) defined criteria that independently predicted neurogenic claudication due to LSS that can help to distinguish this diagnosis from radicular pain caused by disc herniation and aspecific low back pain. A classification score using a weighted set of these criteria was developed. The proposed N-CLASS score ranged from 0 to 19 with a cutoff (10/19) to obtain a specificity of 90.0% and a sensitivity of 82.0%.

• #1 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  In fact, recent MRI studies have shown that mild-to-moderate stenosis can also be found in asymptomatic individuals. Routine electrophysiological tests such as lower extremity electromyography, nerve conduction studies, F-wave, and H-reflex are not helpful in the diagnosis and outcome prediction of LSS. […] However, in the absence of reliable evidence, imaging studies should be considered as a first-line diagnostic test in the diagnosis of degenerative LSS. […] The value of electrophysiological tests, although widely ordered in lumbar radiculopathies, on the diagnosis of LSS and estimating the treatment outcomes are not well known. […] According to the literature review, the World Federation of Neurosurgical Societies (WFNS) Spine Committee has proposed and voted the statements as follows. Statement 3: MRI is the most appropriate noninvasive test and the second is CT scan. CT myelography is appropriated if MRI is contraindicated or inconclusive.

• #1 What Is Cervical Spinal Stenosis?

  https://www.rwjbh.org/treatment-care/neuroscience/neurology/conditions/cervical-spinal-stenosis/

  Cervical spinal stenosis occurs when the vertebrae located in the neck also known as the cervical spine narrows significantly enough to compress the nerve roots of the spinal cord or the cord itself. […] To confirm a diagnosis of cervical spinal stenosis, and must be confirmed with imaging tests that may include: X-ray, Computed tomography (CT), Magnetic resonance imaging (MRI). […] Neck pain and weakness is an indication of possible cervical spinal stenosis.

• #1 Spinal Stenosis: Diagnosis and Spinal Decompression | Joint-surgeon.com

  https://www.joint-surgeon.com/back-and-spine-specialist/expert-treatment-and-diagnose-of-spinal-stenosis

  Spinal stenosis is a narrowing of the spinal canal. Every nerve connecting the brain with the body passes through this spinal canal. Spinal stenosis consequently affects the function central nervous system. Every nerve of the peripheral nervous system providing control and feeling for muscles and limbs passes through the spinal canal. Pressure and narrowing of this passage can result in severe functional deficits and pain. […] A narrowing of the spinal canal is referred to as spinal stenosis. A narrowing of the lateral openings for the nerve roots is referred to as foraminal stenosis. […] To diagnose spinal stenosis your doctor will ask you questions about your symptoms and carry out a comprehensive physical examination. You may also be required to undergo a neurological examination. A variety of imaging procedures may then be used to complete the diagnosis. These include myelography (a procedure in which a liquid contrast medium is injected into the spine before x-rays are taken), computed tomography (CT) and magnetic resonance imaging (MRI).

• #1 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  Lumbar spinal stenosis (LSS) is defined as a degenerative disorder showing a narrowing of the spinal canal. The diagnosis is straightforward in cases with typical neurogenic claudication symptoms and unequivocal imaging findings. […] However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis and clinical complaint. The radiologic diagnosis of LSS is widely discussed in the literature. The best diagnostic test for the diagnosis of LSS is magnetic resonance imaging (MRI). […] However, canal diameter measurements have not gained much consensus from radiologists, whereas qualitative measures, such as cerebrospinal fluid space obliteration, have achieved greater consensus. […] For cases showing typical neurogenic claudication symptoms and unequivocal imaging findings, the diagnosis is straightforward. However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis (computed tomography and MRI) and clinical complaint.

• #1 Spinal Stenosis Symptoms and Diagnosis

  https://www.spine-health.com/conditions/spinal-stenosis/spinal-stenosis-symptoms-and-diagnosis

  Spinal stenosis is most common in the lumbar spine and cervical spine. It rarely occurs in the thoracic spine. Spinal stenosis may also occur in multiple places, such as in both the cervical spine and lumbar spine (tandem stenosis). […] Getting an accurate diagnosis for spinal stenosis typically requires a 3-step process: […] Medical imaging, such as an MRI, can be used to confirm or deny a diagnosis of stenosis. […] While the patient history and physical examination may suggest spinal stenosis, the diagnosis must be confirmed with medical imaging. When imaging shows narrowing of the intervertebral foramen and/or vertebral foramen that corresponds with the patients symptoms, spinal stenosis is diagnosed. An MRI is the most common imaging used to diagnose spinal stenosis, but CT with myelography may be used in cases where MRI is not an option. […] A medical professional observes and palpates (feels) the spine, such as along the neck or lower back. In addition to testing the spines range of motion, clinical tests may also be performed for leg and/or arm strength, reflexes, and sensation (tingling/numbness).

• #2 Lumbar Spinal Stenosis Symptoms And Diagnosis | Pain Centre

  https://www.precisionhealth.com.au/healthcare-services/pain-management/conditions-treated/spinal-conditions/lumbar-spinal-stenosis/

  Lumbar spinal stenosis is a broad term referring to the symptoms which may result from the narrowing of the spinal canal in the lower back. […] Making a diagnosis of lumbar stenosis can sometimes be difficult because the symptoms may mimic other conditions. […] To determine the cause of your symptoms, your neurosurgeon or spinal surgeon may require several investigations. These may include computed tomography (CT), and magnetic resonance imaging (MRI). […] In some situations, such as when you are unable to have an MRI, you may also undergo a CT myelogram, in which CT imaging is performed while a contrast dye is injected into the spinal column.

• #2 Diagnosis of Spinal Stenosis – Huffman Spine Clinic – Spine Surgeon

  https://huffmanclinic.com/diagnosis-of-spinal-stenosis/

  For most patients, the evaluation of spinal stenosis begins with a comprehensive physical and neurological examination followed by confirmatory imaging tests (An X-ray or MRI scan). The tests provide valuable information about the cause of your spinal stenosis and confirm your doctors diagnosis. […] To diagnose your pain as spinal stenosis, your doctor or spine surgeon may ask you questions regarding your symptoms and medical history. […] In addition to the preliminary questions and the physical and neurological examination, your spine surgeon may recommend imaging tests to confirm the diagnosis and the underlying cause of spinal stenosis. […] X-rays are a first-line imaging test performed for spinal stenosis. An X-ray is used to take a detailed picture of your bones. […] MRIs have become the most frequently used study to diagnose spinal stenosis.

• #2 Spinal Stenosis: Diagnosis & Treatment | Och Spine at NewYork-Presbyterian

  https://www.nyp.org/ochspine/spinal-stenosis/treatment

  Diagnostic Testing for Spinal Stenosis […] The symptoms caused by spinal stenosis can be similar to other spinal disorders, so it is important to learn what is causing your discomfort. […] The spine experts at Och Spine at NewYork-Presbyterian may take the following steps to diagnose spinal stenosis: […] Medical history to learn about your symptoms: when did they start, what makes them feel better or worse, how do they limit your activities? […] Physical and neurological exams to assess your range of motion, muscle strength, pain, and sensation. […] Imaging exams such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI). MRI is the best imaging method to see the discs and nerves in and around your spine. […] For cervical stenosis diagnosis, the average space in the cervical spine is 14 mm; 11 mm or less indicates there is stenosis. […] For lumbar stenosis diagnosis, spinal stenosis is considered when the space measures 12 mm or less.

• #2 Lumbar Spinal Stenosis Video

  https://www.spine-health.com/video/lumbar-spinal-stenosis-video

  Spinal stenosis causes a constriction of the space for nerves in the spine. […] With lumbar spinal stenosis, degenerative changes, such as bone spurs, can constrict the space for the nerves in the spinal canal. […] Bone spurs and other problems can also affect the foramen, constricting the space for a nerve root as it exits the spine. […] Symptoms of lumbar spinal stenosis may include pain and/or weakness or numbness that radiate from the lower back into the leg. […] Lumbar Spinal Stenosis Causes and Diagnosis.

• #2 Diagnosis of Spinal Stenosis – Huffman Spine Clinic – Spine Surgeon

  https://huffmanclinic.com/diagnosis-of-spinal-stenosis/

  A CT scan is also similar to an X-ray but sometimes a more detailed imaging study is needed to evaluate your spines anatomical structures (bones, discs, ligaments and nerves). […] Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. […] This option can help look for problems that may be related to spinal stenosis. […] A myelogram is a special version of an X-ray that uses dye to highlight your nerves. […] Blood tests may be ordered to help diagnose the cause behind the spinal stenosis (for example, a bone disease) or rule out other potential diagnoses.

• #2 Lumbar Spinal Stenosis – AANS

  http://www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/

  Diagnosis is made by a neurosurgeon based on history, symptoms, physical examination and test results. […] Imaging studies used may include the following: X-ray: Focuses radiation through the body to create an image and can show the structure of the bones, alignment of the spine and outline the joints. […] CT scan or CAT scan: Creates images by combining multiple X-rays together and can show the shape and size of the spinal canal, its contents and the structures around it with details of the bony anatomy. […] MRI: Creates images by using powerful magnets and computer technology and can show the spinal cord, nerve roots and surrounding areas, as well as enlargement, degeneration and tumors. […] Myelogram: Injects contrast dye into the spinal fluid space (cerebrospinal fluid) to outline the nerves and spinal cord, and show evidence of any pressure affecting these areas; seen on X-ray, sometimes done with a CT scan.

• #2 Diagnosing Spinal Stenosis | NYU Langone Health

  https://nyulangone.org/conditions/spinal-stenosis/diagnosis

  NYU Langone spine specialists can determine the cause of spinal stenosis a narrowing of the spinal canal, the hollow center of the spine that contains the spinal cord and nerves. […] Spinal stenosis is most often diagnosed in people between the ages of 50 and 80. […] In order to make an accurate diagnosis, NYU Langone doctors first ask you for information about your symptoms. […] NYU Langone doctors also use imaging tests to confirm a diagnosis of lumbar or cervical stenosis. […] Doctors frequently recommend X-rays as a first diagnostic imaging test. […] Your doctor may use an MRI scan to see the ligaments, discs, and soft tissues in the spine, including the spinal cord and nerves. […] A CT scan is a series of X-rays that combined provide more comprehensive detail about the spine than a single X-ray image.

• #2 Spinal Stenosis: Diagnosis & Test | Management & Treatment: Pain Care, LLC: Interventional Spine & Pain Management

  https://www.georgiapaincare.com/blog/spinal-stenosis-diagnosis-test-management-treatment

  MRI: Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to create cross-sectional images of the spine. MRI images provide detailed images of the nerves, disks, spinal cord and presence of any tumors. […] CT or CT myelogram: A computed tomography (CT) scan is a combination of X-rays that creates cross-sectional images of the spine. A CT myelogram adds a contrast dye to more clearly see the spinal cord and nerves. […] Because of the complexity of spinal stenosis and the delicate nature of the spine, surgery is usually considered when all other treatment options have failed. […] Surgery options involve removing portions of bone, bony growths on facet joints or disks that are crowding the spinal canal and pinching spinal nerves. […] Types of spine surgery include: […] Laminectomy (decompression surgery): The most common type of surgery for this condition, laminectomy involves removing the lamina, which is a portion of the vertebra. Some ligaments and bone spurs may also be removed. The procedure makes room for the spinal cord and nerves, relieving your symptoms.

• #2 Diagnosing Lumbar Spinal Stenosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1115/p1145.html

  A recent systematic review evaluated the accuracy of diagnostic tests for lumbar spinal stenosis. Fifteen studies of imaging for the diagnosis of the condition were identified. Although most of the studies were of poor quality and the accuracy of the tests varied considerably between studies, the authors of the review concluded that myelography, computed tomography, and MRI appear to have similar accuracy. […] It is important for physicians to consider cauda equina syndrome in the differential diagnosis of back pain and numbness. Any patient with signs or symptoms of possible cauda equina syndrome (e.g., saddle anesthesia, bowel or bladder symptoms) should receive emergent referral to a neurosurgeon. […] After ruling out peripheral vascular disease by confirming that his ankle brachial indices are normal, you order an MRI to confirm lumbar spinal stenosis.

• #2 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  Lumbar spinal stenosis (LSS) is defined as a degenerative disorder showing a narrowing of the spinal canal. The diagnosis is straightforward in cases with typical neurogenic claudication symptoms and unequivocal imaging findings. […] However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis and clinical complaint. The radiologic diagnosis of LSS is widely discussed in the literature. The best diagnostic test for the diagnosis of LSS is magnetic resonance imaging (MRI). […] However, canal diameter measurements have not gained much consensus from radiologists, whereas qualitative measures, such as cerebrospinal fluid space obliteration, have achieved greater consensus. […] For cases showing typical neurogenic claudication symptoms and unequivocal imaging findings, the diagnosis is straightforward. However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis (computed tomography and MRI) and clinical complaint.

• #2

  https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0267892&type=printable

  Diagnostic accuracy of the lumbar spinal stenosis-diagnosis support tool and the lumbar spinal stenosis-self-administered, self-reported history questionnaire […] 10.1371/journal.pone.0267892

• #2 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  Statement 4: there is no correlation between clinical symptoms or function and the presence of anatomic narrowing of the spinal canal on MRI, CT, or myelo-CT. […] Statement 5: qualitative radiologic criteria describe adequately spinal stenosis in central, lateral, or foraminal stenosis. […] Statement 7: routine electrophysiological tests (EMG, nerve conduction study, F-wave response, H-reflex, SSEP, MEP) have no diagnostic value for LSS. […] Statement 8: electrophysiological tests do not predict outcome of patients with LSS.

• #2 Foraminal Stenosis Diagnosis

  https://www.atlanticspinecenter.com/conditions/foraminal-stenosis/diagnosis/

  A proper diagnosis of foraminal stenosis is accomplished through the use of a three step process: […] Your doctor may have X-rays taken of your back to rule out other suspected problems such as tumors, or bone injuries. To get a better look at soft tissue that may be suspected as a cause of foraminal stenosis, an MRI may be ordered. […] Once diagnosis is confirmed, treatment may begin.

• #2 Diagnosis and Treatment of Lumbar Spinal Stenosis

  https://www.patientcareonline.com/view/diagnosis-and-treatment-of-lumbar-spinal-stenosis

  A new review summarized the current evidence about diagnosis and treatment of lumbar spinal stenosis. Pain caused by lumbar spinal stenosis is believed to result from narrowing of the lumbar spinal canal and/or the neural foramina, which causes pressure on the spinal nerve roots as they exit the spine. […] Although approximately 20% of those older than 60 have lumbar spinal stenosis based on imaging, more than 80% of them appear to be asymptomatic.

• #2 SPINAL STENOSIS DIAGNOSIS AND TREATMENT: SURGICAL VS. NON-SURGICAL OPTIONS

  https://www.coastalorthoteam.com/blog/spinal-stenosis-diagnosis-and-treatment-surgical-vs.-non-surgical-options

  If conservative treatments arent helping or if you have disability (for example, trouble walking, constant pain, serious bowel or bladder dysfunction, or excessive numbness in your hands or feet), you may need to see an orthopedist to discuss a surgical option that will work for you. […] If you have signs and symptoms of spinal stenosis (narrowing of the spinal canal in the neck or the lower back), visit a physician to receive a diagnosis. Stenosis can only be confirmed with a full medical history and imaging tests.

• #3 6 Tests Used to Diagnose Spinal Stenosis

  https://www.verywellhealth.com/tests-used-to-diagnose-spinal-stenosis-2549375

  Spinal stenosis is a common condition that can cause symptoms of both back and leg pain. The most common problems associated with spinal stenosis occur when the nerves that go down the legs are compressed in the spinal canal. This can lead to pain, numbness, and weakness in the legs. […] Therefore, when making the diagnosis of spinal stenosis, your healthcare provider will be looking for signs of compression in and around the spinal canal. Below are some of the test commonly used to help make the diagnosis of spinal stenosis. […] The medical history is the most important tool to diagnosis stenosis as it will tell your healthcare provider about your symptoms, possible causes for your spinal stenosis, and other possible causes of back pain. […] The physical examination in a patient with spinal stenosis will give your healthcare provider information about exactly where the nerve compression likely exists.

• #3 Spinal Stenosis Treatment and Diagnosis – Hoag

  https://www.hoag.org/specialties-services/spine/conditions-of-the-spine/spinal-stenosis/

  Spinal stenosis is a narrowing of the spaces within the spine, which can put pressure on the nerves that travel through the spine. This causes a pinching of the spinal cord and/or nerve roots, which leads to pain, cramping, weakness or numbness in the body. […] A rheumatologist will ask about your symptoms and medical history, and conduct a physical exam. Some symptoms he will look for include: Numbness, weakness, cramping or pain anywhere from the neck to the thighs, Pain that goes down the leg, Abnormal bowel/and or bladder function, Loss of sexual function. […] The doctor may order other tests to confirm the diagnosis and determine the seriousness of your condition. These include: An X-ray of the spine to check for osteoarthritis, bone spurs and narrowing of the spinal canal, A computed tomography (CT) scan, which takes more detailed images of the back and spinal canal, A magnetic resonance imaging (MRI) scan of the spine to take pictures of the spinal cord and nerves, An EMG (electromyogram) to check the nerves going to your legs, X-rays of the hips or knees, blood tests, as well as tests to check the circulation in your legs and to rule out other diseases with similar symptoms.

• #3 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  Lumbar spinal stenosis (LSS) is defined as a degenerative disorder showing a narrowing of the spinal canal. The diagnosis is straightforward in cases with typical neurogenic claudication symptoms and unequivocal imaging findings. […] However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis and clinical complaint. The radiologic diagnosis of LSS is widely discussed in the literature. The best diagnostic test for the diagnosis of LSS is magnetic resonance imaging (MRI). […] However, canal diameter measurements have not gained much consensus from radiologists, whereas qualitative measures, such as cerebrospinal fluid space obliteration, have achieved greater consensus. […] For cases showing typical neurogenic claudication symptoms and unequivocal imaging findings, the diagnosis is straightforward. However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis (computed tomography and MRI) and clinical complaint.

• #3

  https://www.sgh.com.sg/patient-care/conditions-treatments/spinal-stenosis

  Spinal stenosis is the narrowing of the spinal canal which contains the nerve roots and spinal cord. This may increase pressure on the neural structures. […] Tests like X-rays, magnetic resonance imaging (MRI) and/or computed tomography (CT) scans can help to diagnose the condition and check for the presence of spondylosis or bone spurs, nerve damage or other changes.

• #3 Spinal Stenosis | Types | Signs & Diagnosis | Treatment

  https://jflowershealth.com/spinal-stenosis/

  Spinal stenosis symptoms are as follows: […] Several types of tests are used to diagnose back stenosis, including: […] Doctors can determine if patients are at high risk for developing spinal stenosis by reviewing their histories, such as genetic conditions, past traumas, procedures, and general lifestyle activities. […] A medical professional will conduct a physical examination—the patient may be asked to perform a variety of movements to determine the source of back stenosis pain. […] A CT scan may be used for spinal stenosis diagnosis. It involves taking various X-ray images and combining them to provide different angles to make up a cross-sectional image of the affected area. […] An MRI uses magnetic and radio waves to provide cross-sectional images of the spine. It can detect ligament and disc damage, tumors, and the source of pressure applied to nerves in the back. […] X-rays use radiation to pick up bone spurs and other changes in bone that may be causing the narrowing of the spine. […] This is diagnostic imaging generally performed by a radiologist. It uses contrast dyes, x-rays, and CT scans to look for issues in the spinal canal.

• #3 Spinal Stenosis: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17499-spinal-stenosis

  Spinal stenosis is the narrowing of one or more spaces within your spinal canal. Your healthcare provider will review your medical history, ask about your symptoms and do a physical exam. You’ll also have imaging tests so your provider can see your spine and determine the exact location, type and extent of the problem. These tests may include: Spine X-ray, MRI, CT scan or CT myelogram.

• #3 6 Tests Used to Diagnose Spinal Stenosis

  https://www.verywellhealth.com/tests-used-to-diagnose-spinal-stenosis-2549375

  An MRI has become the most frequently used study to diagnose spinal stenosis. […] MRIs are helpful at showing exactly what is causing pressure on the nerves of the spine, and the precise location of the problem. […] The myelogram is an X-ray, with an added twist. […] However, they can be very useful in some situations where patients may be unable to have an MRI, for example in patients with cardiac pacemakers. […] A CT scan is also similar to an X-ray, but provides a better degree of differentiation of tissues in your body; in other words, you can see more, because more structures show up on a CT scan. […] A bone scan is not a test that will detect spinal stenosis, but it can be helpful to look for problems that may be related to spinal stenosis.

• #3 Lumbar Spinal Stenosis Diagnosis and Treatment | OrthoGA

  https://www.orthoga.org/specialties/spine-center/lumbar-spinal-stenosis/

  Spinal stenosis, or narrowing of the spinal canal, can affect any part of the spine. […] An accurate diagnosis of lumbar spinal stenosis will ensure that you will be able to take the right steps toward relief from your symptoms. […] Your spine specialist at OrthoGeorgia will ask questions about your symptoms and conduct a complete physical exam. […] Spinal imaging may also be ordered. […] These imaging tests will allow your doctor to review the anatomy and alignment of your spine as part of the diagnostic process. […] This process will also allow your physician to rule out other causes of similar symptoms, such as osteoarthritis of the hip.

• #3 Spinal Stenosis Symptoms and Diagnosis

  https://www.spine-health.com/conditions/spinal-stenosis/spinal-stenosis-symptoms-and-diagnosis

  Spinal stenosis is most common in the lumbar spine and cervical spine. It rarely occurs in the thoracic spine. Spinal stenosis may also occur in multiple places, such as in both the cervical spine and lumbar spine (tandem stenosis). […] Getting an accurate diagnosis for spinal stenosis typically requires a 3-step process: […] Medical imaging, such as an MRI, can be used to confirm or deny a diagnosis of stenosis. […] While the patient history and physical examination may suggest spinal stenosis, the diagnosis must be confirmed with medical imaging. When imaging shows narrowing of the intervertebral foramen and/or vertebral foramen that corresponds with the patients symptoms, spinal stenosis is diagnosed. An MRI is the most common imaging used to diagnose spinal stenosis, but CT with myelography may be used in cases where MRI is not an option. […] A medical professional observes and palpates (feels) the spine, such as along the neck or lower back. In addition to testing the spines range of motion, clinical tests may also be performed for leg and/or arm strength, reflexes, and sensation (tingling/numbness).

• #3

  https://link.springer.com/article/10.1007/s00586-020-06481-w

  Reach a consensus on which diagnostic tests are most important in confirming the clinical diagnosis of lumbar spinal stenosis (LSS). […] The most frequently selected tests included MRI/CT scan, neurological examination and walking test with gait observation. […] This is the first study to reach an international consensus on which diagnostic tests should be used in the clinical diagnosis of LSS. The final recommendation includes three core diagnostic items: neurological examination, MRI/CT and walking test with gait observation. […] If applied, this core set of diagnostic tests can standardize outcomes and improve clinical care of LSS globally.

• #3 Spinal Stenosis: Diagnosis & Treatment | Och Spine at NewYork-Presbyterian

  https://www.nyp.org/ochspine/spinal-stenosis/treatment

  Diagnostic Testing for Spinal Stenosis […] The symptoms caused by spinal stenosis can be similar to other spinal disorders, so it is important to learn what is causing your discomfort. […] The spine experts at Och Spine at NewYork-Presbyterian may take the following steps to diagnose spinal stenosis: […] Medical history to learn about your symptoms: when did they start, what makes them feel better or worse, how do they limit your activities? […] Physical and neurological exams to assess your range of motion, muscle strength, pain, and sensation. […] Imaging exams such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI). MRI is the best imaging method to see the discs and nerves in and around your spine. […] For cervical stenosis diagnosis, the average space in the cervical spine is 14 mm; 11 mm or less indicates there is stenosis. […] For lumbar stenosis diagnosis, spinal stenosis is considered when the space measures 12 mm or less.

• #3 SPINAL STENOSIS | Diagnosis | Restore Medical Partners

  https://restoremedicalpartners.com/diagnosis/spinal-stenosis/

  While there are differences in how stenosis can affect the anatomy, all forms of stenosis are typically referred to as simply spinal stenosis. […] Diagnostic imaging studies for patients with any type of spinal stenosis include either an MRI scan or a CT scan with myelogram (using an X-ray dye in the spinal sac fluid), and sometimes both. […] Certain activities and body position may trigger the symptoms. […] Foraminal stenosis can be pinpointed not only by the CT and MRI scans, but by injecting the suspicious nerve with a small volume of local anesthetic and sometimes with a corticosteroid. […] After the injection a remission of the patients symptoms along with true temporary weakness of the limb is clinically diagnostic and can help the surgeon determine the source of symptoms.

• #3 Diagnosing Spinal Stenosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/back-neck-and-spine/spinal-stenosis/diagnosis.html

  These symptoms also can be caused by many other conditions, which makes spinal stenosis difficult to diagnose. […] In addition to a complete medical history and physical examination, diagnostic procedures for spinal stenosis may include the following: […] X-ray […] MRI […] CT scan

• #3 Spinal Stenosis Diagnosis & Treatment | Mount Sinai – New York

  https://www.mountsinai.org/locations/spine-hospital/conditions/spinal-stenosis

  Spinal stenosis occurs when the spinal canal (which houses the spinal cord and its nerves) narrows, giving the spinal cord and nerves less room to move, it causes irritation and inflammation. At Mount Sinai, we have extensive experience in diagnosing and treating spinal stenosis. […] To diagnose spinal stenosis, we start by taking your medical history and conducting a physical exam to assess your pain and symptoms. We also use an imaging test, such as an X-ray, magnetic resonance imaging (MRI) scan, or computerized tomography (CT) scan.

• #4 Spinal Stenosis: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take

  Doctors use a variety of tools to diagnose spinal stenosis and rule out other conditions. […] Your doctor will likely perform a physical exam, which may check: […] MRI can help diagnose damage or disease of the spine and is particularly useful for imaging the soft tissues, such as the disks, ligaments, and nerve roots in and around the spine. […] Imaging alone will not determine if your spinal stenosis requires treatment. […] If, after trying nonsurgical treatments and medications, you still have symptoms, your doctor may recommend meeting with a surgeon to talk about surgery. […] The decision to have surgery depends on: […] However, not everyone is a candidate for surgery, even if symptoms persist. […] Possible surgeries include: […] Removing and repairing the areas of spine that are creating pressure usually helps decrease symptoms. Most people have less leg pain and can walk better after surgery. However, if nerves were badly damaged before surgery, there may be some remaining pain or numbness or no improvement.

• #4 Spinal stenosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/191/?locale=es_ES

  Spinal stenosis is a condition typically resulting from degenerative changes in the lumbar spine. […] Lumbosacral spine x-rays and computed tomography scans show degenerative changes and possibly spondylolisthesis, but magnetic resonance imaging is the best technique to show neural element compression in the spinal canal and foramina. […] Neurological deficit including sensory or motor loss occurs in up to 30% of patients, and patients may experience severe morbidity from reduction in the ability to walk. […] Key diagnostic factors include presence of risk factors, onset and duration of symptoms, back pain, activity-related back pain, leg pain when walking, stooped posture when walking, leg numbness or paraesthesiae, and absence of examination findings. […] 1st investigations to order include plain x-ray and MRI (T2-weighted). […] Investigations to consider include CT myelography, CT spine, electromyographic (EMG) walking test, and electromyographic paraspinal mapping.

• #4 6 Tests Used to Diagnose Spinal Stenosis

  https://www.verywellhealth.com/tests-used-to-diagnose-spinal-stenosis-2549375

  An MRI has become the most frequently used study to diagnose spinal stenosis. […] MRIs are helpful at showing exactly what is causing pressure on the nerves of the spine, and the precise location of the problem. […] The myelogram is an X-ray, with an added twist. […] However, they can be very useful in some situations where patients may be unable to have an MRI, for example in patients with cardiac pacemakers. […] A CT scan is also similar to an X-ray, but provides a better degree of differentiation of tissues in your body; in other words, you can see more, because more structures show up on a CT scan. […] A bone scan is not a test that will detect spinal stenosis, but it can be helpful to look for problems that may be related to spinal stenosis.

• #4 Studying the Diagnosis and Treatment of Spinal Stenosis :: PBMC Health

  https://www.pbmchealth.org/news-events/blog/studying-diagnosis-and-treatment-spinal-stenosis

  Back pain is a common ailment among Americans. […] One of the most common and painful types of back injury is spinal stenosis. […] To get a proper diagnosis, it’s wise to visit an orthopedic surgery specialist in Suffolk County, NY. […] After your doctor gives you a physical examination and studies your symptoms and medical history, he or she may require imaging tests to come up with a diagnosis. […] There are three principal types of tests he or she may conduct: X-ray, MRI, or CT. […] An MRI (magnetic resonance imaging) uses radio waves and a strong magnet to reveal a cross-section of the spine which is effective for showing damage to the ligaments, as well as places where there may be pressure being put on the nerves. […] If an MRI isn’t an option, your doctor may recommend a CT (computerized tomography) exam.

• #4 Spinal stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/diagnosis-treatment/drc-20352966

  Your healthcare professional may ask about your symptoms and medical history. You may have a physical exam. You also may need an imaging test to help find the problem. […] These tests may include: […] An X-ray of the back can show bone changes that may be making the space within the spinal canal smaller. […] An MRI uses a powerful magnet and radio waves to produce detailed images of hard and soft tissue. The test can detect damage to the disks and ligaments. It also can show whether tumors are present. […] If you can’t have an MRI, you may need a CT scan. This test combines X-ray images taken from many different angles. In a CT myelogram, a contrast dye is injected to outline the spinal cord and nerves. This can show herniated disks, bone spurs and tumors. […] Treatment for spinal stenosis depends on how severe your symptoms are.

• #4 Spinal Stenosis: Diagnosis & Test | Management & Treatment: Pain Care, LLC: Interventional Spine & Pain Management

  https://www.georgiapaincare.com/blog/spinal-stenosis-diagnosis-test-management-treatment

  How is spinal stenosis diagnosed? Your provider at Pain Care will review your medical history, ask about your symptoms and conduct a physical exam. During your physical exam, your healthcare provider may feel your spine, pressing on different area to see if this causes pain. Your provider will likely ask you to bend in different directions to see if different spine positions bring on pain or other symptoms. Your provider will check your balance, watch how you move and walk and check your arm and leg strength. […] Your provider will order imaging test or review current imaging tests to examine your spine and determine the exact location, type and extent of the problem. Imaging studies may include: […] X-rays: X-rays use a small amount of radiation and can show changes in bone structure, such as loss of disk height and development of bone spurs that are narrowing the space in the spine.

• #4 Diagnosis of Spinal Stenosis – Huffman Spine Clinic – Spine Surgeon

  https://huffmanclinic.com/diagnosis-of-spinal-stenosis/

  A CT scan is also similar to an X-ray but sometimes a more detailed imaging study is needed to evaluate your spines anatomical structures (bones, discs, ligaments and nerves). […] Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. […] This option can help look for problems that may be related to spinal stenosis. […] A myelogram is a special version of an X-ray that uses dye to highlight your nerves. […] Blood tests may be ordered to help diagnose the cause behind the spinal stenosis (for example, a bone disease) or rule out other potential diagnoses.

• #4 Lumbar Spinal Stenosis Symptoms And Diagnosis | Pain Centre

  https://www.precisionhealth.com.au/healthcare-services/pain-management/conditions-treated/spinal-conditions/lumbar-spinal-stenosis/

  Lumbar spinal stenosis is a broad term referring to the symptoms which may result from the narrowing of the spinal canal in the lower back. […] Making a diagnosis of lumbar stenosis can sometimes be difficult because the symptoms may mimic other conditions. […] To determine the cause of your symptoms, your neurosurgeon or spinal surgeon may require several investigations. These may include computed tomography (CT), and magnetic resonance imaging (MRI). […] In some situations, such as when you are unable to have an MRI, you may also undergo a CT myelogram, in which CT imaging is performed while a contrast dye is injected into the spinal column.

• #4 Lumbar Spinal Stenosis Causes and Diagnosis

  https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis-causes-and-diagnosis

  A doctor can diagnose stenosis in the lumbar spine based on specific clinical presentations and through medical imaging tests. […] Medical imaging tests help determine the location and severity of stenosis. […] MRI is generally regarded as the most reliable test for diagnosing spinal stenosis. […] Imaging tests may be helpful in locating the site and severity of lumbar spinal stenosis and include: […] A history of clinical symptoms along with imaging evidence is essential to diagnose symptomatic lumbar spinal stenosis. […] Once lumbar spinal stenosis is identified as the cause of the patients symptoms, a definitive treatment plan can be formulated.

• #4

  https://link.springer.com/article/10.1007/s00586-020-06481-w

  Reach a consensus on which diagnostic tests are most important in confirming the clinical diagnosis of lumbar spinal stenosis (LSS). […] The most frequently selected tests included MRI/CT scan, neurological examination and walking test with gait observation. […] This is the first study to reach an international consensus on which diagnostic tests should be used in the clinical diagnosis of LSS. The final recommendation includes three core diagnostic items: neurological examination, MRI/CT and walking test with gait observation. […] If applied, this core set of diagnostic tests can standardize outcomes and improve clinical care of LSS globally.

• #4 Spinal Stenosis Treatment Options – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/orthopaedic-surgery/resources/spinal-stenosis-treatment

  Spinal stenosis is typically diagnosed through a combination of methods, including: […] Medical history, which may include past injuries or illnesses […] Physical examination to determine the extent of limitation of movement, pain or symptoms, and neurologic function (sensation, muscle strength, and reflexes) in the arms and legs […] Imaging, including x-ray, magnetic resonance imaging (MRI), computed tomography (CT), myelogram, and bone scans.

• #5 Diagnosing Lumbar Spinal Stenosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1115/p1145.html

  What is the best way to diagnose lumbar spinal stenosis in patients with leg pain or numbness? […] Lumbar spinal stenosis is an important cause of pain and disability, and surgery is beneficial for appropriately selected patients. Therefore, it is important for primary care physicians to distinguish patients with spinal stenosis from those with musculoskeletal low back pain, peripheral vascular disease, or spinal disk disease. […] Individual signs and symptoms suggestive of lumbar spinal stenosis include older age at onset, longer duration of symptoms, symptoms that worsen with walking or standing, numbness of the lower legs with activity, symptoms that improve with bending forward, and symptoms that worsen with bending backward. The findings that most strongly suggest lumbar spinal stenosis are symptoms that improve with bending forward, urinary disturbance, and intermittent claudication.

• #5 Spinal Stenosis: Diagnosis & Treatment | Och Spine at NewYork-Presbyterian

  https://www.nyp.org/ochspine/spinal-stenosis/treatment

  Diagnostic Testing for Spinal Stenosis […] The symptoms caused by spinal stenosis can be similar to other spinal disorders, so it is important to learn what is causing your discomfort. […] The spine experts at Och Spine at NewYork-Presbyterian may take the following steps to diagnose spinal stenosis: […] Medical history to learn about your symptoms: when did they start, what makes them feel better or worse, how do they limit your activities? […] Physical and neurological exams to assess your range of motion, muscle strength, pain, and sensation. […] Imaging exams such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI). MRI is the best imaging method to see the discs and nerves in and around your spine. […] For cervical stenosis diagnosis, the average space in the cervical spine is 14 mm; 11 mm or less indicates there is stenosis. […] For lumbar stenosis diagnosis, spinal stenosis is considered when the space measures 12 mm or less.

• #5 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  In fact, recent MRI studies have shown that mild-to-moderate stenosis can also be found in asymptomatic individuals. Routine electrophysiological tests such as lower extremity electromyography, nerve conduction studies, F-wave, and H-reflex are not helpful in the diagnosis and outcome prediction of LSS. […] However, in the absence of reliable evidence, imaging studies should be considered as a first-line diagnostic test in the diagnosis of degenerative LSS. […] The value of electrophysiological tests, although widely ordered in lumbar radiculopathies, on the diagnosis of LSS and estimating the treatment outcomes are not well known. […] According to the literature review, the World Federation of Neurosurgical Societies (WFNS) Spine Committee has proposed and voted the statements as follows. Statement 3: MRI is the most appropriate noninvasive test and the second is CT scan. CT myelography is appropriated if MRI is contraindicated or inconclusive.

• #5 Spinal Stenosis: Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/spinal-stenosis/guide/

  How Is Spinal Stenosis Diagnosed? To determine if you have spinal stenosis, your doctor will ask about your symptoms and do a complete physical exam in which they look for signs of spinal stenosis, such as numbness and weakness. It may also be necessary for your doctor to order one of the following tests to confirm the diagnosis: […] X-Ray An X-ray of your back can show bone changes that may be narrowing the spaces in the spinal canal. […] Magnetic Resonance Imaging (MRI) An MRI creates a cross-sectional image of your spine that can detect where nerves in the spinal cord are under pressure. It can also reveal any damage to disks and ligaments. […] Computerized Tomography (CT) Scan If you cant get an MRI, a CT scan can also create images of your spine. It combines X-ray images taken at different angles to produce a cross-sectional picture of your spine.

• #5 Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7322797/

  Statement 4: there is no correlation between clinical symptoms or function and the presence of anatomic narrowing of the spinal canal on MRI, CT, or myelo-CT. […] Statement 5: qualitative radiologic criteria describe adequately spinal stenosis in central, lateral, or foraminal stenosis. […] Statement 7: routine electrophysiological tests (EMG, nerve conduction study, F-wave response, H-reflex, SSEP, MEP) have no diagnostic value for LSS. […] Statement 8: electrophysiological tests do not predict outcome of patients with LSS.

• #5 Spinal stenosis, diagnosis and treatment options | Mayfield Brain & Spine

  https://mayfieldclinic.com/pe-sten.htm

  Magnetic resonance imaging (MRI) is a noninvasive test that uses a magnetic field and radiofrequency waves to give a detailed view of the soft tissues of your spine. […] Myelogram is a specialized X-ray where dye is injected into the spinal canal through a spinal tap. […] Computed Tomography (CT) scan is a safe, noninvasive test that uses an X-ray beam and a computer to make 2-dimensional images of your spine. […] Doppler ultrasound is a noninvasive test that uses reflected sound waves to evaluate blood as it flows through a blood vessel. This test may be performed to rule out peripheral artery disease as a cause of painful leg symptoms.

• #5 Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment – Wu – AME Medical Journal

  https://amj.amegroups.org/article/view/3837/html

  Lumbar spinal stenosis (LSS) is a common spinal disorder in the older population, and the clinical syndrome consisting of pain in the buttock or lower extremity, with or without low back pain and corresponding imaging findings of narrowing of spaces around neural and vascular elements in the lumbar spine. The diagnosis depends on history, symptoms, physical examination, radiographies. […] MRI is commonly used to confirm the LSS. The MRI, which has excellence in observation for soft tissue, is recommended to diagnose LSS by many authors. […] No gold standard diagnostic criterion is widely accepted among physicians. Therefore, to diagnose LSS, we need comprehensive consideration of the history, physical examination, and radiographic images. Most often information including age, neurogenic claudication, the radiating buttock or leg pain which is exacerbated when lumbar extension and relieved at seat or lumbar flexion, wide based gait, and the anatomic narrow observed at radiographic images, sometimes even the results of electromyography and nerve root block is used.

• #5 Spinal stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/diagnosis-treatment/drc-20352966

  Your healthcare professional might prescribe: […] Some anti-seizure drugs, such as gabapentin (Neurontin, Gralise), are used to reduce pain caused by damaged nerves. […] Injecting a steroid medicine into the space around the pinched nerve may help reduce the swelling and relieve some of the pain. […] A lumbar laminectomy involves the removal of the back part of a vertebra in your lower back to make more room within the spinal canal. […] A cervical laminectomy involves the removal of the back part of a vertebra in your neck to make more room within the spinal canal. […] A laminotomy removes only a portion of the lamina, the back part of a spinal bone. It carves a hole just big enough to relieve the pressure in a specific spot. […] In most cases, these operations help reduce spinal stenosis symptoms. But some people’s symptoms stay the same or get worse after surgery.

• #6 Lumbar Spinal Stenosis | Diagnosis & Treatment for Physios

  https://www.physiotutors.com/conditions/lumbar-spinal-stenosis/

  Lumbar Spinal Stenosis (LSS) describes an anatomical narrowing of the spinal canal with subsequent neural compression and is frequently associated with symptoms of neurogenic claudication. A normal anterior-to-posterior (AP) diameter of the spinal canal is somewhere between 22-25mm. In relative LSS, this diameter has narrowed down to 10-12mm. This presentation is often asymptomatic. Absolute LSS shows a spinal canal with an AP diameter of less than 10mm and is often symptomatic. LSS can also be classified according to its anatomy. LSS can be monosegmental or multisegmental, and unilateral or bilateral and occur centrally, laterally in the recess or the intervertebral foramen. […] De Schepper et al. (2013) conducted a systematic review evaluating the accuracy of different items from patient history and clinical tests to diagnose LSS. They found that radiating leg pain that is exacerbated while standing up, the absence of pain when seated, improvement of symptoms when bending forward, and a wide-based gait are most useful to reach a diagnosis. Cook et al. (2019) add that numbness in the perineal region was of diagnostic value as well.

• #6 Spinal Stenosis MRI: What Is Spinal Stenosis and How Is | Scan.com UK

  https://uk.scan.com/health-hub/spinal-stenosis-mri-what-is-spinal-stenosis-and-how-is-it-diagnosed

  Most importantly, we discuss how a spinal stenosis MRI scanthe preferred diagnostic imaging optionoffers a clear and detailed view of your spine to allow investigation and an accurate diagnosis. […] The gold standard test for diagnosing spinal stenosis is a magnetic resonance imaging (MRI) scan. […] A spinal stenosis MRI is a non-invasive, painless procedure that uses a powerful magnetic field and high-frequency radio waves to create highly detailed, cross-sectional images of your spine. Not only is an MRI able to visualise the spinal bones, but it can also show the intervertebral discs, muscles, fat, ligaments, spinal cord, nerve roots, and blood vessels, which allows it to identify the location, extent or stage, and cause(s) of the stenosis. […] An MRI spinal stenosis scan should be your go-to diagnostic imaging test if you are experiencing back pain or other symptoms of stenosis. It can accurately identify the presence of stenosis, the specific location of nerve compression, its severity, and underlying causes. This information will guide your healthcare provider in creating an effective, personalised treatment plan.

• #6

  https://journals.lww.com/spinejournal/fulltext/2013/04150/diagnosis_of_lumbar_spinal_stenosis__an_updated.18.aspx

  Electrodiagnostic studies showed no superior accuracy for conventional electrodiagnostic testing compared with magnetic resonance imaging. […] The most useful clinical findings are radiating leg pain that is exacerbated while standing up, the absence of pain when seated, the improvement of symptoms when bending forward, and a wide-based gait. […] Systematic review on the accuracy of tests used to diagnose lumbar spinal stenosis. The most promising imaging test is magnetic resonance imaging. The diagnostic accuracy for electrodiagnostic testing was only modest.

• #6 Spinal Stenosis Treatment and Diagnosis – Hoag

  https://www.hoag.org/specialties-services/spine/conditions-of-the-spine/spinal-stenosis/

  Spinal stenosis is a narrowing of the spaces within the spine, which can put pressure on the nerves that travel through the spine. This causes a pinching of the spinal cord and/or nerve roots, which leads to pain, cramping, weakness or numbness in the body. […] A rheumatologist will ask about your symptoms and medical history, and conduct a physical exam. Some symptoms he will look for include: Numbness, weakness, cramping or pain anywhere from the neck to the thighs, Pain that goes down the leg, Abnormal bowel/and or bladder function, Loss of sexual function. […] The doctor may order other tests to confirm the diagnosis and determine the seriousness of your condition. These include: An X-ray of the spine to check for osteoarthritis, bone spurs and narrowing of the spinal canal, A computed tomography (CT) scan, which takes more detailed images of the back and spinal canal, A magnetic resonance imaging (MRI) scan of the spine to take pictures of the spinal cord and nerves, An EMG (electromyogram) to check the nerves going to your legs, X-rays of the hips or knees, blood tests, as well as tests to check the circulation in your legs and to rule out other diseases with similar symptoms.

• #6 Diagnosis and Treatment of Lumbar Spinal Stenosis

  https://www.patientcareonline.com/view/diagnosis-and-treatment-of-lumbar-spinal-stenosis

  A new review summarized the current evidence about diagnosis and treatment of lumbar spinal stenosis. Pain caused by lumbar spinal stenosis is believed to result from narrowing of the lumbar spinal canal and/or the neural foramina, which causes pressure on the spinal nerve roots as they exit the spine. […] Although approximately 20% of those older than 60 have lumbar spinal stenosis based on imaging, more than 80% of them appear to be asymptomatic.

• #6 Spinal Stenosis: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take

  Doctors use a variety of tools to diagnose spinal stenosis and rule out other conditions. […] Your doctor will likely perform a physical exam, which may check: […] MRI can help diagnose damage or disease of the spine and is particularly useful for imaging the soft tissues, such as the disks, ligaments, and nerve roots in and around the spine. […] Imaging alone will not determine if your spinal stenosis requires treatment. […] If, after trying nonsurgical treatments and medications, you still have symptoms, your doctor may recommend meeting with a surgeon to talk about surgery. […] The decision to have surgery depends on: […] However, not everyone is a candidate for surgery, even if symptoms persist. […] Possible surgeries include: […] Removing and repairing the areas of spine that are creating pressure usually helps decrease symptoms. Most people have less leg pain and can walk better after surgery. However, if nerves were badly damaged before surgery, there may be some remaining pain or numbness or no improvement.

• #7 Spinal Stenosis Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/344171-overview

  On MRI, findings of spinal stenosis have a variable presentation depending on the specific disease causing the stenosis, as well as associated edema of the related vertebral bodies. […] False-positive findings of central spinal stenosis rarely occur. Gradient-echo images may lead to overestimation of the degree of a lateral recess and neuroforaminal space stenosis. Comparison with T2-weighted axial and sagittal images are recommended in all cases.

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