Possible Causes
prior injury chronic strain degenerative or
metabolic disease congenital abnormalities
Sx
>3mo. or a repeated incapacitating episode low back
pain radiating to butt & leg inc. pain w/ walking, dec.
pain w/ sitting or bending forward numbness
tingling weakness heaviness in legs &
butt
Spinal Stenosis
narrowing of spinal canal
Sciatica
occurs when disc presses on sciatic nerve
rupture/herniation of lumbar disk leads to LBP radiating down
sciatic nerve into posterior thigh
Dx
same as acute LBP Hx & Sx straight leg
raise MRI/CT if trauma or worse
Tx
same as acute LBP except addition of antidepressants
(duloxetine) and/or gabapentin minimally invasive Tx
(epidural corticosteroids, analgesia via implanted devices,
surgery)
Surgical Mgmt
stabilization (vertebroplasty, kyphoplasty)
microdiskectomy decompressive laminectomy spinal
fusion or arthrodesis spinal fusion w/ instrumentation
new tech
(lateral)inter-body fusion X-Stop cyber
knife
Surgical Complications
infection inflammation nerve root injury
dural tears cauda equine syndrome
hematoma non-union/graft failure fat
embolism
Nursing Interventions - Surgical Pt
assess neurologic fx, wound, & pain
positioning DVT prevention brace or corset
bowel program psychosocial support