Differential Diagnosis

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Differential Diagnosis

Spinal Stenosis

- is the narrowing of the spinal canal

• can affect any part of the spinal canal, but more commonly in the lumbar and cervical regions
• can be caused by thickening of ligaments, formation of bony spurs, or even spondylolisthesis.

Symptoms of Lumbar Spinal Stenosis

• feel pain, weakness, numbness in legs,calves and buttocks
• increase when the person walks
• decreases when the person bends forward or sits down.
• pain could be a form of radiation or cramping like feeling.
• rare cases, person might also have PARAPLEGIA.

Cauda Equina Syndrome

• is the compression of nerve roots below the spinal level.
• causes the cutting of sensation and movements
• nerve roots that control the function of the bladder and bowel are especially vulnerable to damage.

Signs and Symptoms

• low back pain
• unilateral or bilateral sciatica
• bowel and bladder disturbances
• 2 types of back pain - local and radicular

- local : results from soft tissue and vertebral body irritation

- radicular : sharp stabbing pain as a result of compression of dorsal nerve roots

• Urinary Issues : retention , decreased urethral sensation ,difficult initiating micturition * and later bladder incontinence

Lumbar Disc Herniation

• is the rupturing of the nucleus pulposus through the annulus fibrosus
• the gel like nucleus pulposus can causes irritation to spinal nerves
• pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc.

Signs and Symptoms

• feel radiating pain to the low back area, down one / both legs , sometimes into feet called sciatica
• may feel severe electric-like feeling when walking, sitting or standing
• may feel tingling sensation and numbness along with pain
• leg muscle weakness is present
• knee or ankle reflex lost
• can have severe loss of bowel / bladder control (incontinency )

Spondylolisthesis

• is the slipping forward of the vertebral column due to defects in the articulating process
• the articulating process are arranged in a manner that prevents forward movement of the vertebra due to the human body’s centre of gravity.
• when the condition occurs, kyphotic deformity occurs.
• few types of spondylolisthesis is present ( congenital , traumatic and pathologic )
• occurs almost always at L4/L5

Signs and Symptoms

• pain can be caused by either by the lysis of structures *
• pain can also be caused due to involvement of the nerves.
• walking and postural abnormalities
• intensity is increased upon activity