Spinal Stenosis
Post Rehab Goals and Objectives:
- Improve Lower Extremity and Trunk Strength
- Improve Cardiovascular Capacity
- Improve Lumbar Functional Capacity
- Develop Independent Exercise Program
- Improve Flexibility
Anatomy / Physiology / Pathology
Spinal stenosis implies narrowing of the spinal canal with possible subsequent neural compression. The stenosis classification is based on anatomy and etiology. There are two anatomic classifications of stenosis: central canal and lateral recess stenosis.
Central canal stenosis (central stenosis) occurs at the IV disc level, the compression may elicit neurologic claudication or pain into the buttocks, thighs or lower legs. The narrowing impinges on the nerve roots causing radiating pain particularly with trunk extension and upright standing. The central stenosis on physical exam, presents with a slight forward flexed posture. The client reports increased pain with lumbar extension. The client will have pain into the dermatome of the affected nerve root. The client may also have weakness, pain and numbness/tingling. Compression on the cauda equina may cause bowel and bladder dysfunction.
The lateral recess stenosis (lateral stenosis) client presents with increased pain with spinal flexion. Pain may radiate into the thighs, buttocks and is worse with sitting. This client has unilateral pain into the dermatome of the compressed nerve root.