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Home / Equine Research Bank / Rev Bras Ortop (Sao Paulo) / Degenerative Lumbar Spinal Stenosis.
Revista brasileira de ortopedia2020; 56(1); 9-17; doi: 10.1055/s-0040-1712490

Degenerative Lumbar Spinal Stenosis.

Abstract: Degenerative lumbar spinal stenosis is the most frequent cause of low back pain and/or sciatica in the elderly patient. Epidemiology, pathophysiology, clinical manifestations and testing are reviewed in a wide current bibliographic investigation. The importance of the relationship between clinical presentation and imaging study, especially magnetic resonance imaging (MRI), is emphasized. Prior to treatment indication, it is necessary to identify the precise location of pain, as well as the differential diagnosis between neurological and vascular lameness. Conservative treatment combining medications with various physical therapy techniques solves the problem in most cases, while therapeutic testing with injections, whether epidural, foraminal or facetary, is performed when pain does not subside with conservative treatment and before surgery is indicated. Injections usually perform better results in relieving sciatica symptoms and less in neurological lameness. Equine tail and/or root decompression associated or not with fusion is the gold standard when surgical intervention is required. Fusion after decompression is necessary in cases with segmental instability, such as degenerative spondylolisthesis. When canal stenosis occurs at multiple levels and is accompanied by axis deviation, whether coronal and/or sagittal, correction of axis deviations should be performed in addition to decompression and fusion, especially of the sagittal axis, in which a lumbar lordosis correction is required with techniques that correct the rectified lordosis to values close to the pelvic incidence.
Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).
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Publication Date: 2020-07-23 PubMed ID: 33627893PubMed Central: PMC7895619DOI: 10.1055/s-0040-1712490Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research paper discusses the causes, symptoms, diagnosis, and treatment options for Degenerative Lumbar Spinal Stenosis, a common source of back pain and sciatica in elderly patients.

Epidemiology and Pathophysiology

  • The research article starts by discussing the epidemiology and pathophysiology of Degenerative Lumbar Spinal Stenosis, a prevalent cause of lower back pain and sciatica in the elderly population.
  • It implies that understanding the development and prevalence of this condition is crucial for making accurate diagnoses and implementing effective treatments.

Clinical Manifestations and Testing

  • The paper provides a detailed description of the clinical manifestations and diagnostic tests for the condition.
  • These include symptoms such as severe lower back pain, numbness, weakness, and cramping that can be exacerbated by standing or walking.
  • The authors emphasize the diagnostic importance of magnetic resonance imaging (MRI) because of its ability to provide high-resolution images of the spine and detect any abnormalities.

Treatment Options and Techniques

  • The article mentions various conservative treatments that can alleviate the symptoms of lumbar spinal stenosis in most cases, including both medication and physical therapy techniques.
  • It also discusses the use of therapeutic injections (epidural, foraminal, or facetary) as an alternative treatment method when pain persists despite conservative therapy.
  • The authors point out that these injections are particularly effective in relieving sciatica symptoms and less so in treating neurological lameness.

Surgical Interventions

  • For cases where conservative therapy and injections fail, the study discusses the role of surgical interventions.
  • The gold standard surgical procedure involves decompression of the equine tail and/or spinal roots, with or without spinal fusion.
  • The decision to perform spinal fusion is mainly dependent on whether there’s segmental instability as seen in degenerative spondylolisthesis.
  • The authors highlight that when canal stenosis spans multiple vertebral levels and is accompanied by skeletal deviations, it’s necessary to correct these discrepancies in addition to decompression and fusion procedures.
  • Sagittal axis deviations, in particular, require correction of lumbar lordosis to values closely mimicking the natural pelvic incidence using specific surgical techniques.

Cite This Article

APA
Hennemann S, de Abreu MR. (2020). Degenerative Lumbar Spinal Stenosis. Rev Bras Ortop (Sao Paulo), 56(1), 9-17. https://doi.org/10.1055/s-0040-1712490

Publication

Revista brasileira de ortopedia
ISSN: 0102-3616
NlmUniqueID: 0123326
Country: Germany
Language: English
Volume: 56
Issue: 1
Pages: 9-17

Researcher Affiliations

Hennemann, Sergio
  • Serviço de Ortopedia, Grupo da coluna, Hospital Mãe de Deus, Porto Alegre, RS, Brasil.
de Abreu, Marcelo Rodrigues
  • Radiologia Musculoesquelética, Hospital Mãe de Deus, Porto Alegre, RS, Brasil.

Conflict of Interest Statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

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