Degenerative lumbar spinal stenosis: evaluation and management
Autor: | Frank P. Cammisa, Alexander P. Hughes, Matthias Pumberger, Paul S. Issack, Matthew E. Cunningham |
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Rok vydání: | 2012 |
Předmět: |
medicine.medical_specialty
Spinal stenosis medicine.medical_treatment Neurogenic claudication Lumbar vertebrae Spinal Stenosis medicine Back pain Humans Minimally Invasive Surgical Procedures Orthopedics and Sports Medicine Lumbar Vertebrae business.industry Laminectomy Lumbar spinal stenosis medicine.disease Decompression Surgical Magnetic Resonance Imaging Surgery Radiography Intervertebral disk medicine.anatomical_structure Treatment Outcome Anesthesia Thecal sac medicine.symptom business |
Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons. 20(8) |
ISSN: | 1067-151X |
Popis: | Degenerative lumbar spinal stenosis is caused by mechanical factors and/or biochemical alterations within the intervertebral disk that lead to disk space collapse, facet joint hypertrophy, soft-tissue infolding, and osteophyte formation, which narrows the space available for the thecal sac and exiting nerve roots. The clinical consequence of this compression is neurogenic claudication and varying degrees of leg and back pain. Degenerative lumbar spinal stenosis is a major cause of pain and impaired quality of life in the elderly. The natural history of this condition varies; however, it has not been shown to worsen progressively. Nonsurgical management consists of nonsteroidal anti-inflammatory drugs, physical therapy, and epidural steroid injections. If nonsurgical management is unsuccessful and neurologic decline persists or progresses, surgical treatment, most commonly laminectomy, is indicated. Recent prospective randomized studies have demonstrated that surgery is superior to nonsurgical management in terms of controlling pain and improving function in patients with lumbar spinal stenosis. |
Databáze: | OpenAIRE |
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