Abos - Spine - Lumbar Spine - Stenosis

Front 1

What is the principal cause of lateral recess stenosis?

Back 1

Superior articular facet hypertrophy

Front 2

What are three causes of foraminal stenosis?

Back 2

Foraminal HNP
Decreased disk height
Pars defect

Front 3

In foraminal stenosis, what are the critical foraminal height and the critical posterior disk height?

Back 3

Foraminal height < 15mm
Posterior disk height >4mm

Front 4

Are tension signs present with central or lateral stenosis?

Back 4

Not generally

Front 5

Why is hyperreflexia not seen with lumbar stenosis? What is the most common neurologic deficit on exam?

Back 5

Lower motor neuron (LMN) problem, so no hyperreflexia
L5 most common root for weakness

Front 6

Is there a proven benefit to epidural steroids?

Back 6

No consistent benefit in controlled studies

Front 7

What type of injection has most consistently demonstrated symptomatic benefit?

Back 7

Transforaminal nerve block

Front 8

What are the three indications for fusion after decompression of stenosis?

Back 8

Degenerative spondylolisthesis
Instability/iatrogenic injury
Degenerative scoliosis

Front 9

Is there a proven benefit to instrumentation for stenosis? How about symptomatic relief?

Back 9

No proven benefit to instrumentation
Improved symptom relief without instrumentation

Front 10

What age group has poorer decompression outcomes? Are there other prognostic factors?

Back 10

Young patients do worse
Patients with multiple comorbidities do worse

Front 11

What is the typical mechanism of extraforaminal L5 root compression? What is the ideal radiographic view to identify it?

Back 11

L5 impingement between sacral ala and L5 transverse process
Ferguson's view