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Algorithmic approach to the management of the patient with lumbar spinal stenosis

Lumbar spinal stenosis (LSS) is a clinical syndrome of buttock or lower extremity pain, which may occur with or without back pain that is associated with diminished space available for the neural and vascular elements in the lumbar spine. There are several categories of LSS, of which degenerative LSS is the most common and the focus of this supplement. The normal process of aging leads to degenerative changes in the lumbar spine. The result is gradual narrowing (stenosis) of the central spinal canal, the area under the facet joints (subarticular recess), and the neural foramina. Significant stenosis produces compression of the underlying neural and vascular elements that results in the typical painful symptoms.

This supplement provides recommendations from a consensus panel of experts on how to treat and manage LSS, including assessment and diagnosis and surgical and non-surgical treatment plans. The supplement also includes a detailed LSS management algorithm for use by the family physician.

Article PDF
SupplJFP_LSS.pdf
Author and Disclosure Information

 

Terence P. Doorly, MD;

Associate Chief of Neurosurgery, The North Shore Medical Center, Salem, Massachusetts, Medical Director, Neurosurgery and Spine, The Musculoskeletal Center, Peabody, Massachusetts

Cheryl L. Lambing, MD;

Assistant Clinical Professor, Department of Family Medicine, University of California, Los Angeles, Ventura County Medical Center, Family Medicine Residency, Director, Family Care Center, Director, Osteoporosis Center, Ventura County, Ventura, California

Gerard A. Malanga, MD;

Clinical Professor, UMDNJ–New Jersey Medical School, Newark, New Jersey, Director, Pain Management, Overlook Pain Center, Summit, New Jersey

Philip M. Maurer, MD;

Director, Interventional Spine Program, Booth Bartolozzi Balderston Orthopaedics/PENN Orthopaedics, Department of Orthopaedics Pennsylvania Hospital, Philadelphia, Pennsylvania

Ralph F. Rashbaum, MD

Instructor, Department of Anesthesiology & Pain Therapy, Texas Tech University Health Science Center, Co-founder, Texas Back Institute, Lubbock, Texas

Issue
The Journal of Family Practice - 59(8)
Publications
MDedge Family Medicine
The Journal of Family Practice
Topics
Pain
Page Number
S1-S8
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Medical Education Library
Supplements
Author and Disclosure Information

 

Terence P. Doorly, MD;

Associate Chief of Neurosurgery, The North Shore Medical Center, Salem, Massachusetts, Medical Director, Neurosurgery and Spine, The Musculoskeletal Center, Peabody, Massachusetts

Cheryl L. Lambing, MD;

Assistant Clinical Professor, Department of Family Medicine, University of California, Los Angeles, Ventura County Medical Center, Family Medicine Residency, Director, Family Care Center, Director, Osteoporosis Center, Ventura County, Ventura, California

Gerard A. Malanga, MD;

Clinical Professor, UMDNJ–New Jersey Medical School, Newark, New Jersey, Director, Pain Management, Overlook Pain Center, Summit, New Jersey

Philip M. Maurer, MD;

Director, Interventional Spine Program, Booth Bartolozzi Balderston Orthopaedics/PENN Orthopaedics, Department of Orthopaedics Pennsylvania Hospital, Philadelphia, Pennsylvania

Ralph F. Rashbaum, MD

Instructor, Department of Anesthesiology & Pain Therapy, Texas Tech University Health Science Center, Co-founder, Texas Back Institute, Lubbock, Texas

Author and Disclosure Information

 

Terence P. Doorly, MD;

Associate Chief of Neurosurgery, The North Shore Medical Center, Salem, Massachusetts, Medical Director, Neurosurgery and Spine, The Musculoskeletal Center, Peabody, Massachusetts

Cheryl L. Lambing, MD;

Assistant Clinical Professor, Department of Family Medicine, University of California, Los Angeles, Ventura County Medical Center, Family Medicine Residency, Director, Family Care Center, Director, Osteoporosis Center, Ventura County, Ventura, California

Gerard A. Malanga, MD;

Clinical Professor, UMDNJ–New Jersey Medical School, Newark, New Jersey, Director, Pain Management, Overlook Pain Center, Summit, New Jersey

Philip M. Maurer, MD;

Director, Interventional Spine Program, Booth Bartolozzi Balderston Orthopaedics/PENN Orthopaedics, Department of Orthopaedics Pennsylvania Hospital, Philadelphia, Pennsylvania

Ralph F. Rashbaum, MD

Instructor, Department of Anesthesiology & Pain Therapy, Texas Tech University Health Science Center, Co-founder, Texas Back Institute, Lubbock, Texas

Article PDF
SupplJFP_LSS.pdf
Article PDF
SupplJFP_LSS.pdf

Lumbar spinal stenosis (LSS) is a clinical syndrome of buttock or lower extremity pain, which may occur with or without back pain that is associated with diminished space available for the neural and vascular elements in the lumbar spine. There are several categories of LSS, of which degenerative LSS is the most common and the focus of this supplement. The normal process of aging leads to degenerative changes in the lumbar spine. The result is gradual narrowing (stenosis) of the central spinal canal, the area under the facet joints (subarticular recess), and the neural foramina. Significant stenosis produces compression of the underlying neural and vascular elements that results in the typical painful symptoms.

This supplement provides recommendations from a consensus panel of experts on how to treat and manage LSS, including assessment and diagnosis and surgical and non-surgical treatment plans. The supplement also includes a detailed LSS management algorithm for use by the family physician.

Lumbar spinal stenosis (LSS) is a clinical syndrome of buttock or lower extremity pain, which may occur with or without back pain that is associated with diminished space available for the neural and vascular elements in the lumbar spine. There are several categories of LSS, of which degenerative LSS is the most common and the focus of this supplement. The normal process of aging leads to degenerative changes in the lumbar spine. The result is gradual narrowing (stenosis) of the central spinal canal, the area under the facet joints (subarticular recess), and the neural foramina. Significant stenosis produces compression of the underlying neural and vascular elements that results in the typical painful symptoms.

This supplement provides recommendations from a consensus panel of experts on how to treat and manage LSS, including assessment and diagnosis and surgical and non-surgical treatment plans. The supplement also includes a detailed LSS management algorithm for use by the family physician.

Issue
The Journal of Family Practice - 59(8)
Issue
The Journal of Family Practice - 59(8)
Page Number
S1-S8
Page Number
S1-S8
Publications
MDedge Family Medicine
The Journal of Family Practice
Publications
MDedge Family Medicine
The Journal of Family Practice
Topics
Pain
Article Type
Article
Display Headline
Algorithmic approach to the management of the patient with lumbar spinal stenosis
Display Headline
Algorithmic approach to the management of the patient with lumbar spinal stenosis
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Medical Education Library
Supplements
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DISCLOSURES

 

Dr. Doorly reports he was previously on the speakers bureau for Medtronic. Dr. Lambing reports she is on the speakers bureau for Medtronic. Dr. Malanga reports he is on advisory boards of Cephalon, Endo Pharmaceuticals, and Forest Laboratories. Dr. Maurer reports he is a consultant for Medtronic. Dr. Rashbaum reports he receives royalties and intellectual property rights from, is on the advisory board of, and has ownership interest in Medtronic. This supplement to The Journal of Family Practice was sponsored by the Primary Care Education Consortium and was supported by an educational grant from Medtronic.

 

This supplement to The Journal of Family Practice was sponsored by the Primary Care Education Consortium and was supported by an educational grant from Medtronic.

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