Multilevel Lumbar Spondylosis with Spinal Stenosis

Abstract

Narrowing of the spinal canal or foramina is a common finding in spine imaging of the elderly. We present a case of multilevel lumbar spondylosis with spinal stenosis. Mr X, 79-year-old male with underlying Diabetes Mellitus, hypertension and minor coronary artery disease presented to the hospital with low back pain radiating to lower limb for 4 years, progressively worsening, affecting the ability to walk steadily for prolonged period, and the worst pain score is 9/10, and the least pain score is 4/10. It was associated with intermittent neuropathic symptoms like numbness from waist downwards, nocturnal claudication, and weakness. Otherwise, he had no fever, no vomiting, no headache, no chest and abdominal pain, no respiratory distress, palpitations, and no urinary incontinence. Management includes continue insulin as patient has diabetes mellitus, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, anti-seizure drugs, opioids, and start physical therapy. Most patients have a progressive presentation and are offered non operative management as first treatment strategy.