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I mostly see an active duty population (so much younger, smarter, faster, better looking, and better smelling than your patients.)
Anyway, I often see severe spinal stenosis and they NEVER have the typical symptoms we classically assign to central canal stenosis.
It made me start to wonder about this.
Do you guys think that it is possible (and I haven't' seen anyone write about this) that because of age, blood flow, etc. - that spinal stenosis in a younger population presents completely different?
It just seems that way to me. They all present with back pain with classical radicular symptoms.
I know that the teaching of spinal stenosis is that the neurogenic symptoms is NOT per-say from the stenotic lesion, but more from a stiff ligament that doesn't allow movement (thus can't bulge) and this is why MILD works (frees up the ligament to move and bulge). So it would follow that in a younger population, even though stenosis exists, the ligament is probably much more elastic and moveable - thus making symptoms different.
Anyway, I often see severe spinal stenosis and they NEVER have the typical symptoms we classically assign to central canal stenosis.
It made me start to wonder about this.
Do you guys think that it is possible (and I haven't' seen anyone write about this) that because of age, blood flow, etc. - that spinal stenosis in a younger population presents completely different?
It just seems that way to me. They all present with back pain with classical radicular symptoms.
I know that the teaching of spinal stenosis is that the neurogenic symptoms is NOT per-say from the stenotic lesion, but more from a stiff ligament that doesn't allow movement (thus can't bulge) and this is why MILD works (frees up the ligament to move and bulge). So it would follow that in a younger population, even though stenosis exists, the ligament is probably much more elastic and moveable - thus making symptoms different.
