Ward Class:

Lumbar Foraminal
Stenosis
Shehrazade
Ahmad,GROUP 1
PRESENTED TO: SIR ALLEN BIENE, RN
Patient’s Data Base
Name of Patient: Elyas F.
Address: Polomolok
Religion: Roman Catholic
Age: 62 years old
Civil Status: Married
Nationality: Filipino
Height: 172 cm / 5.6 ft
Weight: 93 kg
BMI: 30-34.9 (Obesity Class I)
Date and Time of Admission: February 17, 2024 / 9:33 AM
Attending Physician: Dr. M, C, P
What is lumbar foraminal
Stenosis?

Foraminal stenosis is a condition that

happens when narrowing in parts of
your spine causes compression of your
spinal nerves. Most cases don’t cause
symptoms, even with severe narrowing.
Types of lumbar Stenosis
Central Canal Stenosis: This is when the
tunnel-like space in the center of your spine,
where the spinal cord runs, becomes narrow.
It can squeeze the spinal cord and cause
symptoms like leg pain and weakness.

Foraminal Stenosis: This happens when the

openings between the bones in your spine,
where nerves come out, get too small. It can
press on the nerves and cause symptoms like
pain, tingling, and weakness in your legs.
Causes of Lumbar Foraminal Stenosis

Bone spurs: Extra bone growth around the openings between the vertebrae,
narrowing the space for nerves to pass through.
Herniated discs: The soft cushion-like discs between the vertebrae bulge out and
press on the nerves, causing narrowing of the foraminal openings.
Thickened ligaments: The tough bands of tissue that hold the vertebrae together
can become thicker, narrowing the foraminal openings and squeezing the nerves.
Degenerative changes: Wear and tear on the spine over time can lead to changes
that cause narrowing of the foraminal openings, such as arthritis or disc
degeneration.
Signs of Foraminal Lumbar Stenosis

Leg pain or sciatica, often on one side

Numbness or tingling in the legs or feet
Weakness in the legs or feet
Difficulty walking or standing for long periods
Pain that worsens with certain movements, such as bending backward or twisting
Decreased reflexes in the affected leg
Pain that may radiate down the leg, following the path of the affected nerve
Diagnostic Test
X-ray: Provides images of the spine to identify bone abnormalities such as bone spurs or
narrowed foraminal openings.
Magnetic Resonance Imaging (MRI): Produces detailed images of the spine and surrounding
structures to visualize any compression of nerves or spinal cord.
Computed Tomography (CT) scan: Offers cross-sectional images of the spine to assess for
bone abnormalities, such as herniated discs or bone spurs.
Electromyography (EMG): Measures electrical activity in muscles to assess nerve function
and identify nerve compression in the lumbar region.
Nerve conduction study: Measures how quickly electrical impulses travel along nerves to
determine if there is nerve damage or compression.
Medical Management
Pain management: Using over-the-counter or prescription medications to alleviate pain
and discomfort associated with lumbar foraminal stenosis.
Physical therapy: Engaging in exercises and stretches to improve flexibility, strengthen
muscles, and alleviate pressure on the nerves.
Epidural steroid injections: Administering corticosteroids directly into the affected area
to reduce inflammation and alleviate pain.
Surgery: In severe cases or when conservative treatments fail, surgical procedures such
as laminectomy or foraminotomy may be recommended to relieve pressure on the
nerves.
Nursing Management
Pain management: Administer prescribed pain medications to alleviate discomfort and
improve mobility.
Positioning: Instruct the patient on proper body mechanics and positions to reduce pressure
on the affected nerves and alleviate symptoms.
Physical therapy: Refer the patient to physical therapy for exercises aimed at improving
flexibility, strength, and posture to relieve pressure on the nerves.
Assistive devices: Provide or recommend the use of assistive devices such as braces or canes to
support the spine and reduce strain on the affected area.
Education: Educate the patient on lifestyle modifications, including proper lifting techniques,
weight management, and regular exercise, to prevent exacerbation of symptoms and
promote overall spine health.
Surgical consultation: Consider referral to a surgeon for evaluation of surgical options in cases
where conservative management fails to provide relief or symptoms worsen.
HEALTH TEACHING
Proper body mechanics: Teach the patient how to lift, bend, and move correctly to avoid putting excess
strain on the spine.
Posture improvement: Educate on maintaining good posture to reduce pressure on the spine and
prevent worsening of symptoms.
Exercise: Encourage low-impact activities like walking or swimming to strengthen muscles supporting
the spine and improve flexibility.
Pain management techniques: Teach relaxation exercises, heat or cold therapy application, and
medication adherence for pain relief.
Assistive devices: Instruct on the proper use of aids like braces or canes to support the spine and
improve mobility.
Weight management: Advice on maintaining a healthy weight to reduce stress on the spine and
alleviate symptoms.
Smoking cessation: Emphasize the importance of quitting smoking, as it can worsen spinal health and
impede healing.
Follow-up care: Stress the need for regular check-ups with healthcare providers to monitor the
condition and adjust treatment as necessary.
Thank you