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The differences between a medical subluxation and a chiropractic "vertebral subluxation" create confusion and difficulties when it comes to following official ICD-9 and ICD-10 coding. In a 2014 article in Dynamic Chiropractic [ 21 ] by a chiropractor who is a certified professional coder , these difficulties were discussed in detail.
Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis.
DISH is diagnosed by findings on x-ray studies. Radiographs of the spine will show abnormal bone formation (ossification) along the anterior spinal ligament. The disc spaces, facet and sacroiliac joints remain unaffected. Diagnosis requires confluent ossification of at least four contiguous vertebral bodies. [2]
A spinal subluxation is visible on X-rays and can sometimes impinge on spinal nerve roots, causing symptoms in the areas served by those roots. In the spine, such a displacement may be caused by a fracture, spondylolisthesis, rheumatoid arthritis, [7] severe osteoarthritis, falls, accidents and other traumas.
The lumbar (or lower back) region is the area between the lower ribs and gluteal fold which includes five lumbar vertebrae (L1–L5) and the sacrum. In between these vertebrae are fibrocartilaginous discs , which act as cushions, preventing the vertebrae from rubbing together while at the same time protecting the spinal cord .
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. [6] Symptoms may include pain, numbness, or weakness in the arms or legs. [1] Symptoms are typically gradual in onset and improve with leaning forward. [1]
Spondylolisthesis is when one spinal vertebra slips out of place compared to another. [1] While some medical dictionaries define spondylolisthesis specifically as the forward or anterior displacement of a vertebra over the vertebra inferior to it (or the sacrum), [2] [3] it is often defined in medical textbooks as displacement in any direction.
MRI of the lumbar spine showing spinal stenosis. Neurogenic claudication is one subtype of the clinical syndrome of lumbar spinal stenosis (LSS). [9] No gold standard diagnostic criteria currently exist, but evaluation and diagnosis is generally based on the patient history, physical exam, and medical imaging. [1]