What Is Lumbar Spondylosis With Radiculopathy? - …
spondylolisthesis explanation free
When spondylosis occurs, lumbar radiculopathy--with pain, tingling, numbness, and muscle weakness--may result. Often, the first signs of lumbar spondylosis are morning stiffness and pain. It's quite common for more than one vertebra to be affected by spondylosis. Since the lumbar spine carries the bulk of the body weight, degeneration of the vertebrae support may be most noticeable with repetitive movements such as bending or lifting.
Spondylolisthesis - PhysioWorks
Identifying Lumbar Spondylosis
Diagnosis of lumbar spondylosis consists of a physical examination, neurological examination (to assess sensation and motor function), imaging studies (such as x-rays, CT scan, or MRI), and possibly discography. Once a diagnosis of lumbar spondylosis is confirmed, a treatment regimen is established. Conservative treatment consists of muscle relaxants, anti-inflammatory medication, and physical therapy. If conservative treatment is unsuccessful in relieving the symptoms, the patient is then referred to a spinal surgeon to determine if surgery is an option.
L5 radiculopathy is a common problem that has several causes
Broward Spine Institute a Florida Spine Treatment Center and Comprehensive Pain Management Center offers state-of-the-art evaluation and treatment of disorders of the cervical, thoracic and lumbar spine, specializing in initial evaluations and treatment of disc disease and disc herniations, spinal stenosis, fractures, tumors, inflammatory conditions, myelopathy, radiculopathy, infections, and failed back.
Low Back Pain – Cleveland Clinic
Neurogenic Claudication 50% - worse with standing, relieved by flexion - claudication distance is variable - sensory changes - normal pulses 4. Cauda Equina 5% ROM - normal lumbar forward flexion - pain on extension Minimal tenderness & spasm Neurological deficit 50% - sensory alteration 30% - weakness 20% AP - facet hypertrophy / osteophyte formation Lateral - mild forward slip Dynamic Views - >10° or 4mm = objective instability Degeneration of facet Demonstrate stenosis with spondylolithesis Don't tend to progress past Grade II Do well if have no neurological symptoms Often need surgery for neurological claudication / stenosis Mild symptoms / short duration / unfit for surgery Activity modification / analgesics / physio Weinstein et al N Eng J Med 2007 - RCT of operative v non operative, multicentred - operative group had substantial improvement in pain and function at 2 years Pearson et al Spine 2009 - SPORT - RCT of operative v non operative - operative group had significantly better outcomes - grade 1 better outcome than grade 2 with surgery - dynamic instability better outcome than static - failure of non operative treatment - radiculopathy / neurogenic claudication - progressive neurological defect - bladder or bowel symptoms 1. Decompress + fusion - demonstrated superior results in degenerative spondylolithesis Herkowitz et al Spine 1991 - fusion & decompression alone had better results at 3 years than decompression alone - slip increased 95% vs 30% 2. Instrumentation - instrumentation increases fusion rate - ?