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

Presentation Diagnosis  Options 
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