6 responses to “Spinal stenosis — practice tips”

  1. Should we call it Neurogenic claudication rather than pseudoclaudication?

  2. If the true definition of claudication is applied -pain in muscles due to lack of oxygen as result of reduced blood flow- then pseudoclaudication is probably the correct term, not neurogenic claudication which is the term I would have used
    previous to reading the practice tip article..

  3. Might be useful to consider duration of symptoms prior to decisions to refer for imagining or surgical consult

  4. One part of the physical examination which is not discussed here is the SIFFT test where the levels of the posterior superior iliac spines (PSISs) are compared to assess for displaced sacroiliac (SI) joints. X-rays, CT scans and MRIs are unable to visualize these highly irregular joints whose displacement is the most likely cause of “nonspecific” low back pain the source of 90% of such pain. The 2 minute corrective exercise to replace a displaced SI joint provides immediate relief to 90% of those who perform it. Check it out at: Bertrand H, Reeves KD, Mattu R, et al. Self-Treatment of Chronic Low Back Pain Based on a Rapid and Objective Sacroiliac Asymmetry Test: A Pilot Study. Cureus. 2021 Nov 11;13(11):e19483. doi: 10.7759/cureus.19483. PMID: 34912624; PMCID: PMC8665897.

  5. I agree that radiologic stenosis does not always correlate well with clinical disability. However, when the patient says that a year ago they could stand without leaning forward or walk without stopping & sitting for, say, 20 minutes, whereas they now have to lean on the counter/ shopping trolley or sit down to relieve increasing weakness in their legs and pain after 5 minutes, this is significant & disabling progression. When associated with moderate or severe central and/or foraminal stenosis, particularly if it is most marked at one spinal level, a surgical opinion is needed. Demographics dictate that this will be an area of significant growth in neurosurgical practice.

  6. The pole walking and walker use is a gift..thank you

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