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Spinal stenosis

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Spinal stenosis

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High Yield Notes
15 pages
Flashcards

Spinal stenosis

8 flashcards
Questions

USMLE® Step 1 style questions USMLE

2 questions
Preview

A 35-year-old man comes to the clinic due to back pain. Upon entering the clinic, the patient is observed to be limping and appears in pain. He discloses back pain for the past few months that has been progressively worsening. Two days ago, he felt severe pain while lifting a box at home. The patient now describes the pain as dull, 7/10 in severity, which worsens with movement and radiates to the left thigh. He has noticed numbness in the perianal region while using the toilet. Vitals are within normal limits. On physical examination, focal tenderness is noticed over the lumbar and paraspinal area. There is a loss of sensation around the perianal area but a normal anal sphincter tone. Knee jerk reflex is normal but the ankle reflex is absent on the left. Strength is 5/5 on the right and 4/5 in the left gluteus maximus and hamstring muscles. Which of the following features will prompt the need for emergent imaging?

Summary
Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.