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Lumbar Spondylosis Treatment & Management

  • Author: Bruce M Rothschild, MD; Chief Editor: Brian H Kopell, MD  more...
Updated: Oct 23, 2015

Medical Therapy

Because back pain is an unrelated finding of lumbar spondylosis, seek the real cause of the patient's back or sciatica-type symptoms. Do not assume that the patient's symptoms are related to osteophytosis. Look for an actual cause of a patient's symptoms. If actual symptomatic nerve root impingement occurs, 2 days of absolute bed rest is indicated. If that does not solve the problem, then surgical excision is indicated. Medication is not indicated in the absence of complications.


Surgical Therapy

Surgical excision is performed for impingement-documented sciatica that is unresponsive to 2 days of absolute bed rest.



Nerve compression from posterior osteophytes is a possible complication only if a neuroforamen is reduced to less than 30% of normal.

If lumbar spondylosis projects into the spinal canal, spinal stenosis is a possible complication.

If osteophytes disappear, look for aortic aneurysm. Aortic aneurysms can cause pressure erosions of the adjacent vertebrae. If osteophytes are present, the first sign is often erosion of those osteophytes, so they are no longer visible.

An isolated report of a bony L4 mass pressing on the duodenum has been described.


Outcome and Prognosis

Lumbar spondylosis is usually not a source of morbidity.

For excellent patient education resources, see eMedicineHealth's patient education articles Fibromyalgia and Chronic Pain.

Contributor Information and Disclosures

Bruce M Rothschild, MD Professor of Medicine, Northeast Ohio Medical University; Adjunct Professor, Department of Biomedical Engineering, University of Akron; Research Associate, University of Kansas Museum of Natural History; Research Associate, Carnegie Museum

Bruce M Rothschild, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Rheumatology, International Skeletal Society, New York Academy of Sciences, Sigma Xi, Society of Skeletal Radiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Brian H Kopell, MD Associate Professor, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai

Brian H Kopell, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, International Parkinson and Movement Disorder Society, Congress of Neurological Surgeons, American Society for Stereotactic and Functional Neurosurgery, North American Neuromodulation Society

Disclosure: Received consulting fee from Medtronic for consulting; Received consulting fee from St Jude Neuromodulation for consulting; Received consulting fee from MRI Interventions for consulting.

Additional Contributors

Michael G Nosko, MD, PhD Associate Professor of Surgery, Chief, Division of Neurosurgery, Medical Director, Neuroscience Unit, Medical Director, Neurosurgical Intensive Care Unit, Director, Neurovascular Surgery, Rutgers Robert Wood Johnson Medical School

Michael G Nosko, MD, PhD is a member of the following medical societies: Academy of Medicine of New Jersey, Congress of Neurological Surgeons, Canadian Neurological Sciences Federation, Alpha Omega Alpha, American Association of Neurological Surgeons, American College of Surgeons, American Heart Association, American Medical Association, New York Academy of Sciences, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

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Anteroposterior view of lumbar spine. Vertical overgrowths from margins of vertebral bodies represent osteophytes.
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