Learning Issue - Learning Issue: Where does Spinal Stenosis...

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Learning Issue: Where does Spinal Stenosis occur? Name: Michael Holmes Definition Stenosis can be generalized or localized to specific anatomical areas of the cervical, thoracic, or lumbar spine. It is most common in the lumbar region, but cervical stenosis also occurs frequently. It has been reported rarely in the thoracic spine. Spinal stenosis can be localized or diffuse, affecting multiple levels as in congenital stenosis Causes The most common type of spinal stenosis is caused by degenerative arthritis of the spine, including Forestier disease, and is characterized by hyperostosis and spinal rigidity in elderly patients. Other processes, such as Paget disease, fluorosis, kyphosis, scoliosis, and fracture with canal narrowing, may result in spinal stenosis. Congenital forms caused by disorders such as achondroplasia and dysplastic spondylolisthesis are much less common. Hypertrophy and ossification of the posterior longitudinal ligament and diffuse idiopathic skeletal hyperostosis syndrome also may result in an acquired form of spinal stenosis, which is usually confined to the cervical spine. Risk Factors old age disk degeneration Pathophysiology Central spinal stenosis denotes involvement of the area between the facet joints, which is occupied by the dura and its contents. Stenosis in this region usually is caused by protrusion of a disc, bulging anulus, osteophyte formation, or buckled or thickened ligamentum flavum Signs and Symptoms See table below What to look for in physical exam Generally, physical findings with all forms of spinal stenosis are inconsistent. Distal pulses should be felt and confirmed to be strong, and internal and external rotation of the hips in extension should be full, symmetrical, and painless. Straight leg raising and sciatic tension tests usually are normal. The neurological examination usually is normal, but some abnormality may be
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This note was uploaded on 02/18/2012 for the course PAS 600 - 601 taught by Professor Garrubba during the Fall '10 term at Chatham University.

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Learning Issue - Learning Issue: Where does Spinal Stenosis...

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