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an 80yr old women complains of a 4 month h/o worsening gait and low back pain that is worse on walking,,she denies any trauma and takes only iron supple ,,on PE she has hypoactive muscle stretch reflexes in the legs ,,x ray of lumbosacral region show degenerative changes that seem age appr,,DX
disc herniat5ion
lumbas stenosis
myopathy
cerviacal stenosis

lumbas stenosis

how can u differentiate bet lstenosis and herniation

herniation, pain is worsen when sitting.

in the given q this infomation is not given

Agree with B.

Here is the UW educational objective about the differential diagnosis of these two:

herniated disc: pain becomes worsened with sitting and lumbar flexion and therefore is different from pain of spinal stenosis.

What's the answer math? Thank you.

the correct ans is stenosis
bcoz of impingement of motor AND sensory roots

herniation=impingement on sensory OR motor root