Lumbar Spinal Stenosis and Neurogenic Claudicati on

Česká verzia

Authors: S. Voháňka; B. Mičánková Adamová
Authors place of work: Neurologická klinika LF MU a FN Brno
Published in the journal: Cesk Slov Neurol N 2009; 72/105(5): 405-417
Category: Minimonography

Summary

Lumbar spinal stenosis (LSS) is an osteo‑ligamentous narrowing of the spinal or nerve root canal in the lumbar area. Most frequently, LSS results from secondary spondylotic and spondylarthrotic changes. Congenital stenosis is one of the less frequent causes of nerve structure compression but represents an important risk factor in the development of secondary changes. Neurogenic claudication is a typical pathognomic sign of LSS. According to our experience, LSS is often under- diagnosed, it is a frequent cause of lower back pain and contributes to impaired mobility in older age. Clinical picture can be divided into three main areas: 1. neurogenic claudication; 2. low back pain or nerve root pain; 3. signs of permanent multiple nerve root damage (chronic cauda equine syndrome). Magnetic resonance is the main imaging examination technique that facilitates evaluation of the entire spinal canal in the lumbar area, enables measurement of the dural sac area and high quality evaluation of soft structures (intervertebral discs, ligamentum flavum, contact with nerve roots etc). Conservative treatment, including exercise, ortheses, analgesics when needed for pain, non‑steroidal anti‑inflammatory drugs and muscle relaxants, is recommended in mild to moderate forms of the disease without progression. More severe forms with progression require surgical treatment (decompression, stabilization).

Key words:
lumbar spinal stenosis – ne urogenic cla udicati on – gait disorders – low back pain

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