Conservative therapy includes a soft collar, cervical traction, anti-inflammatory drugs, and mild analgesics. Decompressive laminectomy is used sparingly to halt disease progression or to stabilize the myelopathy. Spinal Stenosis A narrowing of the spinal canal, causing pressure on the sciatic nerve roots and occasionally on the cord. The pressure on the spinal cord may result from bony or soft tissue encroachment on the spinal cord or lumbosacral nerve roots. Mild to moderate low back pain and symptoms of radicular nerve root compression may be present.
Physical findings are often nonspecific.
The presence of brisk peripheral pulses helps exclude peripheral vascular disease as a diagnosis. However, many asymptomatic elderly persons have the pathologic changes of spinal stenosis on imaging studies. Thus, careful clinical judgment must be used to determine whether spinal stenosis found on x-ray is the cause of the patient's symptoms. Treatment for most patients includes an initial course of analgesics and exercise. If a patient does not respond to this approach or if function is severely compromised, spinal decompression by surgery is indicated.