Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical practice guideline.

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

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Outcome of Surgical Treatment of Degenerative Lumbar Spinal Stenosis.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v14i1.14838 ◽

2016 ◽

Vol 14 (1) ◽

pp. 25-28

Author(s):

Bishnu Babu Thapa ◽

Sushil Rana Magar ◽

Pankaj Chand ◽

Bachhu Ram KC

Keyword(s):

Conservative Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Leg Pain ◽

Walking Distance ◽

Neurogenic Claudication ◽

Long Term Outcome ◽

Degenerative Lumbar Spinal Stenosis ◽

Vas Score ◽

Lumbar Spinal

Introduction: Spinal stenosis mostly occur in lumbar spine and causes back pain, leg pain & neurogenic claudication. Although conservative treatment is mainstay, decompression with or without fusion (with or without instrumentation) can be considered in non-responsive cases. However, long term outcome of the surgery is controversial. The aim of our study was to analyze the outcome of surgery in lumbar spinal stenosis in terms of post-operative pain and claudication distance.Methods: A prospective analysis of patients who underwent decompression or decompression with fusion (with or without instrumentation), after failure of 3-6 months conservative treatment, for lumbar spinal stenosis were conducted. Only those who were operated and followed up for at least two years were included.Their preop and postop VAS score and walking distance compared.Results: Of 22 cases enrolled in this study, VAS score was improved in 21 patients and walking distance increased. Only one patient complained of increase in pain score at 24 months.Conclusion: Operative management is a good option for selected patients, 21 out of 22 have improved VAS and claudication distance in our study

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Clinical Outcomes for Neurogenic Claudication Using a Multimodal Program for Lumbar Spinal Stenosis: A Retrospective Study

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2014.12.006 ◽

2015 ◽

Vol 38 (3) ◽

pp. 188-194 ◽

Cited By ~ 12

Author(s):

Carlo Ammendolia ◽

Ngai Chow

Keyword(s):

Retrospective Study ◽

Clinical Outcomes ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Neurogenic Claudication ◽

Lumbar Spinal

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Reply to “Comments on Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria”

The Spine Journal ◽

10.1016/j.spinee.2018.01.021 ◽

2018 ◽

Vol 18 (5) ◽

pp. 913-914

Author(s):

Stéphane Genevay ◽

Delphine S. Courvoisier ◽

Steven J. Atlas

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Classification Criteria ◽

Neurogenic Claudication ◽

Clinical Classification ◽

Lumbar Spinal

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Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010712 ◽

2013 ◽

Cited By ~ 27

Author(s):

Carlo Ammendolia ◽

Kent J Stuber ◽

Elisabeth Rok ◽

Raja Rampersaud ◽

Carol A Kennedy ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Nonoperative Treatment ◽

Neurogenic Claudication ◽

Lumbar Spinal

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A Review of Lumbar Spinal Stenosis with Intermittent Neurogenic Claudication: Disease and Diagnosis

Pain Medicine ◽

10.1093/pm/pnz161 ◽

2019 ◽

Vol 20 (Supplement_2) ◽

pp. S32-S44 ◽

Cited By ~ 1

Author(s):

Timothy Deer ◽

Dawood Sayed ◽

John Michels ◽

Youssef Josephson ◽

Sean Li ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Imaging Techniques ◽

Treatment Options ◽

Surgical Techniques ◽

Individual Case ◽

Current Data ◽

Neurogenic Claudication ◽

Disc Disease ◽

Lumbar Spinal

Abstract Objective Lumbar spinal stenosis (LSS) is a degenerative spinal condition affecting nearly 50% of patients presenting with lower back pain. The goal of this review is to present and summarize the current data on how LSS presents in various populations, how it is diagnosed, and current therapeutic strategies. Properly understanding the prevalence, presentation, and treatment options for individuals suffering from LSS is critical to providing patients the best possible care. Results The occurrence of LSS is associated with advanced age. In elderly patients, LSS can be challenging to identify due to the wide variety of presentation subtleties and common comorbidities such as degenerative disc disease. Recent developments in imaging techniques can be useful in accurately identifying the precise location of the spinal compression. Treatment options can range from conservative to surgical, with the latter being reserved for when patients have neurological compromise or conservative measures have failed. Once warranted, there are several surgical techniques at the physician’s disposal to best treat each individual case.

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