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A 71-year-old male presents with bilateral leg pain for the last two years.His pain is exacerbated when walking and is relieved when his sits or bends forward.
He notes occasional periods where his legs feel weak, but motor examination reveals 5/5 motor strength throughout his bilateral lower extremities.
He has diminished sensation on the medial aspect of his feet bilaterally.
His preoperative and postoperative radiographs are shown in Figure A and B respectively.
His past medical history is significant for osteoarthritis, hypertension, and smoking 1.5 packs per day for greater than 35 years.
Which variable in this patient’s history has been reported to be associated with lower functional outcomes after this surgery?
A 57-year-old woman with a past medical history of diabetes mellitus and arrythmias, requiring prior insertion of a pacemaker, presents with severe bilateral leg pain for 12 months.
Extensive nonoperative treatment with therapy and epidural steroid injections have failed to provide any relief of her symptoms.
What would be the most appropriate next step in treatment?
Figures A demonstrates an upright lateral lumbar spine radiograph.
There is 3mm of translation on flexion and extension radiography.