At the Orthopedics Grand Rounds held approximately 1 year ago, Dr Steven Garfin discussed the management of spinal stenosis in a woman who has a long history of lower back pain and fibromyalgia.1 Dr Garfin stressed the importance of the history and physical examination in making a diagnostic assessment, particularly in a patient with multiple problems. Dr Garfin also discussed the appropriateness of surgical treatment for spinal stenosis, emphasizing symptomatic relief in the legs vs the back. We asked the patient and her primary care doctor to comment on what has transpired in the past year.
Miss W, THE PATIENT:
I had a triple laminectomy performed by a neurosurgeon in September 1995 and I feel great. I have no pain at all in my legs. My back pain has improved a little bit. I walk 3 to 4 miles daily and have lost 25 pounds. The fibromyalgia is off
Daley J, Delbanco T, Walzer J. A 50-Year-Old Woman With Disabling Spinal Stenosis, 1 Year Later. JAMA. 1996;276(1):66. doi:10.1001/jama.1996.03540010068033