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The listing states: "Lumbar spinal stenosis resulting in neurogenic claudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b." [47] The regulation is written specifically for lumbar stenosis. [48]
Neurogenic claudication (NC), also known as pseudoclaudication, is the most common symptom of lumbar spinal stenosis (LSS) and describes intermittent leg pain from impingement of the nerves emanating from the spinal cord. [1] [2] Neurogenic means that the problem originates within the nervous system.
Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.
Spinal or neurogenic claudication may be differentiated from arterial claudication based on activity and position. In neurogenic claudication, positional changes lead to increased stenosis (narrowing) of the spinal canal and compression of nerve roots and resultant lower extremity symptoms. Standing and extension of the spine narrows the spinal ...
Spinal stenosis involves narrowing of the spinal canal and typically presents in patients greater than 60 years of age. Neurogenic claudication can occur in cases of severe lumbar spinal stenosis and presents with symptoms of pain in the lower back, buttock or leg that is worsened by standing and relieved by sitting.
Surgical treatment that includes a laminectomy is the most effective remedy for severe spinal stenosis; however, most cases of spinal stenosis are not severe enough to require surgery. When the disabling symptoms of spinal stenosis are primarily neurogenic claudication and the laminectomy is done without spinal fusion, there is generally a more ...
Narrowing of the lumbar spinal canal causes a clinical condition known as neurogenic claudication, characterized by symptoms such as lower back pain, leg pain, leg numbness, and leg weakness that worsens with standing and walking and improves with sitting and lying down. [6]
Other common causes include disc herniation, spinal stenosis, trauma, and spinal tumors. [4] Spinal stenosis results from bony growths (osteophytes) or thickened ligaments that cause narrowing of the spinal canal over time. [4] This causes leg pain with increased activity, a condition called neurogenic claudication. [4]