Exercise related weakness of back or legs

Symptoms

• Weakness of buttock / thigh / shin / calf, aggravated by exercise / walking / twisting. Slow but accelerating onset often associated with easement stooping or crouching
• Weakness ± wasting of both buttocks / thighs / shins / calves. Weakness aggravated by exercise / walking / lifting. Slow but accelerating onset often associated with easement stooping or crouching

Diagnosis

Gradual onset of weakness of buttock or knee power / foot push off / increasing foot drop Lateral Recess

Stenosis (narrowing of the exit foramen / pathway for the nerve root. Often under diagnosed

Endoscopic Lumbar Decompression & Foraminoplasty / Open decompression ± medial facetectomy / Fusion / Interspinous spacer

Gradual onset of weakness ± wasting of buttock or thigh / foot push off / increasing foot drop Axial Stenosis.

Usually associated with intervertebral body slippage. Often over diagnosed in favour of Lateral Recess

Stenosis Endoscopic Lumbar Decompression & Foraminoplasty / Open decompression ± medial facetectomy ± Laminectomy or laminoplasty / Fusion / Interspinous spacer