Lumbar Spondylosis Treatment & Management

  • Author: Bruce M Rothschild, MD; Chief Editor: Allen R Wyler, MD   more...
 
Updated: Jul 6, 2011
 

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.
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Surgical Therapy

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

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Complications

  • Nerve compression from posterior osteophytes is a possible complication only if a neuroforamen is reduced to less than 30% of normal.
  • Posterior disk height reduction to less than 4 mm or foraminal height to less than 15 mm is compatible with diagnosis of osteophyte-induced nerve compression.[7]
  • 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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Outcome and Prognosis

Lumbar spondylosis is usually not a source of morbidity.

For excellent patient education resources, visit eMedicine's Muscle Disorders Center. Also, see eMedicine's patient education articles Fibromyalgia and Chronic Pain.

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Contributor Information and Disclosures
Author

Bruce M Rothschild, MD  Professor of Medicine, Northeastern Ohio Universities Colleges of Medicine and Pharmacy; 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, and Society of Skeletal Radiology

Disclosure: Nothing to disclose.

Specialty Editor Board

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, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School

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

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Allen R Wyler, MD  Former Medical Director, Northstar Neuroscience, Inc

Allen R Wyler, MD is a member of the following medical societies: American Academy of Neurological and Orthopaedic Surgeons, American Association of Neurological Surgeons, and Society of Neurological Surgeons

Disclosure: Nothing to disclose.

Paolo Zamboni, MD  Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy

Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

Allen R Wyler, MD  Former Medical Director, Northstar Neuroscience, Inc

Allen R Wyler, MD is a member of the following medical societies: American Academy of Neurological and Orthopaedic Surgeons, American Association of Neurological Surgeons, and Society of Neurological Surgeons

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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