Lumbar Spondylosis Treatment & Management
- Author: Bruce M Rothschild, MD; Chief Editor: Brian H Kopell, MD more...
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 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.
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