Lumbar Spinal Stenosis Diagnosis 6 Key Questions Defined and an MLB Star’s Status.
A recent international study defined that there are six key questions clinicians can use to more accurately diagnose lumbar spinal stenosis. The study showed that clinicians become 80% certain of lumbar spinal stenosis by asking these six crucial queries. Results were presented at the International Society for the Lumbar Spine (ISSLS) Annual Meeting.
The task force initially agreed on 14 questions deemed important in the diagnosis of lumbar spinal stenosis and understanding a patient’s history. There was also input of physicians with at least 20 years of experience diagnosing lumbar spinal stenosis.
The common indicators of lumbar spinal stenosis found in the study were:
- Leg or buttocks pain while walking or in motion
- Leaning forward to try and relieve pain symptoms
- Sitting down to try and relieve pain symptoms
- Normal foot pulses
- Relief with rest
- Lower extremity weakness
The results of the study produced standardized criteria that can be used in a variety of clinical settings, but it did not account for physical examination or other diagnostic tests. Further plans are to continue the study for remaining aspects of diagnosis.
LSS on the Ball Field—the David Wright spinal stenosis story continues
Speaking of LSS—about a week ago, New York Mets’ star David Wright, who we first discussed in a recent CES blog, spoke cautiously but optimistically with reporters about a return this season. His GM Sandy Alderson reports that treatment hasn’t changed much for his narrowing of the spinal canal in the lower back in the last few weeks.
Both fans and the media are confused—Wright’s coach has also recently suggested that a return is on the horizon.
Wright has played in only eight games this season and has been on the disabled list since April 15th. He’s under the care of orthopedic spine surgeon Dr. Robert Watkins, based in Marina del Rey, California. Wright has reportedly received anti-inflammatory injections in addition to physical therapy. Surgery does not seem to be an imminent option for the third baseman, according to all reports.
Dr. Watkins is an orthopedic surgeon to the stars, having operated on Peyton Manning’s neck and Dwight Howard’s back. He’s also cared for Wayne Gretzky, Don Mattingly, Troy Aikman, and Joe Montana. Watkins’ opinion is that while surgery is an option, it should be avoided in Wright’s case at all costs. For this MD, patience is a virtue.
Does Lumbar Spinal Stenosis Surgery Encourage Athletic Comebacks?
Alderson insists that while he hasn’t talked about statistics on lumbar spinal stenosis surgery efficacy with Dr. Watkins, he knows it isn’t the “preferred approach in this case”. In short, the New York Mets are avoiding LSS surgery at all costs. Of course, recovery time is always a concern in baseball, whether it is a back injury or an arm surgery like Tommy John’s.
While spinal stenosis surgery is a viable option for many people, in pro baseball, it sounds fear. In July 1996, former Met Lenny Dykstra, then with the Philadelphia Phillies, failed to play again after a summertime spinal procedure. He was placed on the voluntary retired list in 1998, but the Philadelphia neurosurgeon who performed the procedure says it was a success. Post-op, he was back to exercising, free of pain, and clear to play, Dykstra’s surgeon Dr. Simeone said of that time in 1996.
Orthopedic surgeon Stefan Prada of the Laser Spine Institute in Tampa, FL says he would already have started considering surgery for Wright based on months of trying conservative treatment.
The opinions, depending on the area of expertise across the entire Wright situation, seem to vary. The only conclusion defined at this moment is that there has been no decision made either on future treatment or Wright’s status for the remaining 2015 season.
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