Lumbar Stenosis with Necrosis of Foot a Diagnostic Approach

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34362 ◽

2021 ◽

pp. 140-146

Author(s):

Mansi Deshmukh ◽

Priyanka Telang ◽

Rupali Thorat

Keyword(s):

Spinal Canal ◽

Clinical Presentation ◽

Diagnostic Approach ◽

Lumbar Stenosis ◽

Lateral Nerve ◽

Lumbar Decompression ◽

Progressive Loss

Lumbar stenosis is characterised by decrease in spinal canal, neural foramina, lateral nerve .with the narrowing or compression which results in pain and progressive loss. The main objective of the review was to present etiology, pathogenesis and most importantly its clinical presentation along with the necrosis of foot . Study shows that lumbar stenosis can show its improvement by surgical Lumbar decompression and endoscopy.

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Clinical and Radiographic Correlation (According to CT) in Patients with Degenerative Lumbar Spinal Stenosis

Medical Visualization ◽

10.24835/1607-0763-2017-5-124-130 ◽

2017 ◽

pp. 124-130 ◽

Cited By ~ 1

Author(s):

S. G. Mlyavykh ◽

A. Y. Aleynik ◽

A. E. Bokov ◽

M. V. Rasteryaeva ◽

M. A. Kutlaeva

Keyword(s):

Ct Scan ◽

Spinal Canal ◽

Clinical Manifestations ◽

Intervertebral Discs ◽

Morphometric Parameters ◽

Neurogenic Claudication ◽

Clinical Group ◽

Lumbar Stenosis ◽

Degenerative Lumbar Spinal Stenosis ◽

Lumbar Spinal

Сomputed tomography (CT) is widely used in the diagnosis of degenerative pathology of the lumbar spine, but the relationship between clinical manifestations of lumbar stenosis and its anatomical prerequisites has not been sufficiently studied to date.The objective: to determine the significance of the morphometric parameters of lumbar stenosis according to CT scans and to establish their relationship with the prevailing symptoms of the disease.Material and methods. Seventy-five consecutive patients with clinically significant lumbar stenosis who underwent CT scan before surgery were enrolled in this study. The average values of thirteen different morphometric parameters were calculated at LIII–SI levels of the intervertebral discs and of the pedicels in the axial and sagittal views. The possibility of classification of clinical observations and the correlation of morphometric parameters with the clinical forms of lumbar stenosis were investigated using discriminant and logistic regression analysis. Results. CT scan with high probability allocates patients with predominant symptoms of neurogenic claudication or bilateral radiculopathy. The most significant morphometric predictors of this clinical group are the depth of the lateral recesses and the cross-sectional area of the spinal canal.Conclusion. CT scan significantly expands the informative value of magnetic resonance imaging and can be used in planning the decompressive stage of the surgery intervention in patients with lumbar spinal canal stenosis.

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The value of cervical MRI in surgical lumbar canal stenosis patients

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00249-1 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Omar Youssef Abdalla ◽

Hieder Al-Shami ◽

Heba Medhat Maghraby ◽

Abdelrhman Enayet

Keyword(s):

Clinical Presentation ◽

Adult Population ◽

Cervical Canal ◽

Lumbar Stenosis ◽

Cervical Stenosis ◽

Lumbar Canal Stenosis ◽

Cervical Canal Stenosis ◽

Canal Stenosis ◽

Tandem Spinal Stenosis ◽

A Prospective Study

Abstract Background The prevalence of cervical canal stenosis alone is estimated to be present in 4.9% of the adult population. Co-existence of dual pathology may complicate clinical presentation and necessitates a wise and individually based decision process. Objectives To estimate the co-existence of cervical canal stenosis in surgical lumbar canal stenosis patients and its reflection on decision-making regarding surgery. Methods It is a prospective study that was conducted on 70 cases with symptomatic lumbar canal stenosis by investigating them for cervical canal stenosis clinically and radiologically. Results The co-existence of cervical and lumbar canal stenoses was seen in 62 cases (88.57%); cases with relative cervical stenosis were 25 (35.714%) and absolute cervical stenosis was 37 (52.857%). Cases with no cervical stenosis were 8 (11.428%) and cases with relative lumbar stenosis were 22 (31.428%), while cases with absolute lumbar stenosis were 48 (68.571%). Cases with symptomatic cervical canal stenosis were 30 (42.857%). Cases with asymptomtic cervical canal stenosis were 32 (45.71%). Conclusion Tandem spinal stenosis (TSS) is not uncommon and MRI cervical spine should be done for every lumbar canal stenosis patient especially if indicated by history or clinical examination.

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Percutaneous Endoscopic Lumbar Decompression for Lumbar Lateral Spinal Canal Stenosis: Classification of Lateral Region of Lumbar Spinal Canal and Surgical Approaches

World Neurosurgery ◽

10.1016/j.wneu.2018.07.133 ◽

2018 ◽

Vol 119 ◽

pp. e276-e283 ◽

Cited By ~ 8

Author(s):

Yu Wang ◽

Qingyu Dou ◽

Jin Yang ◽

Lifeng Zhang ◽

Yuqing Yan ◽

...

Keyword(s):

Spinal Canal ◽

Spinal Canal Stenosis ◽

Surgical Approaches ◽

Lateral Region ◽

Lumbar Decompression ◽

Canal Stenosis ◽

Lumbar Spinal Canal ◽

Lumbar Spinal

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Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts

Neurosurgical FOCUS ◽

10.3171/2015.7.focus15259 ◽

2015 ◽

Vol 39 (4) ◽

pp. E9 ◽

Cited By ~ 37

Author(s):

Daipayan Guha ◽

Robert F. Heary ◽

Mohammed F. Shamji

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Patient Characteristics ◽

Neurogenic Claudication ◽

Lumbar Stenosis ◽

Lumbar Decompression ◽

Radiographic Outcomes ◽

Fusion Data ◽

Canal Enlargement ◽

The Impact

OBJECT Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability. METHODS A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed. RESULTS A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%). CONCLUSIONS Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.

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Diagnostic approach in children with unusual symptoms of acquired hypothyroidism. When to look for pituitary hyperplasia?

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2015-0157 ◽

2016 ◽

Vol 29 (3) ◽

Cited By ~ 8

Author(s):

Mirjana Kocova ◽

Nikolina Zdraveska ◽

Rozana Kacarska ◽

Elena Kochova

Keyword(s):

Pericardial Effusion ◽

Clinical Assessment ◽

Autoimmune Thyroiditis ◽

Clinical Presentation ◽

Diagnostic Procedures ◽

Diagnostic Approach ◽

Growth Delay ◽

Pituitary Hyperplasia ◽

Unusual Symptoms

AbstractPituitary hyperplasia secondary to primary longstanding hypothyroidism has been reported in the literature in adults and rarely in children.Here we present the clinical presentation and diagnostic procedures in eight children with pituitary hyperplasia due to autoimmune thyroiditis, highlighting common findings, such as growth delay, fatigue or gaining weight, but also exceptional findings such as pericardial effusion, rhabdomyolysis, isolated hypertrichosis, and Van Wyk-Grumbach syndrome, which have rarely or never been described.Surprisingly no thyroid enlargement was detected. We discuss the unusual presenting signs of autoimmune thyroiditis that should raise the suspicion of pituitary hyperplasia. We suggest that a more elaborate clinical assessment and even modification of the diagnostic approach to autoimmune thyroiditis is needed in order to avoid its serious complications.

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Application of a correlation between the lumbar Torg ratio and the area of the spinal canal to predict lumbar stenosis: a study of 420 postmortem subjects

Journal of Orthopaedics and Traumatology ◽

10.1007/s10195-013-0237-z ◽

2013 ◽

Vol 14 (3) ◽

pp. 207-212 ◽

Cited By ~ 2

Author(s):

Navkirat S. Bajwa ◽

Jason O. Toy ◽

Nicholas U. Ahn

Keyword(s):

Spinal Canal ◽

Lumbar Stenosis

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Successful operative management of an upper lumbar spinal canal stenosis resulting in multilevel lower nerve root radiculopathy

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.143216 ◽

2015 ◽

Vol 6 (01) ◽

pp. 108-111 ◽

Cited By ~ 2

Author(s):

Shearwood McClelland ◽

Stefan S. Kim

Keyword(s):

Spinal Canal ◽

Operative Management ◽

Spinal Canal Stenosis ◽

Neurogenic Claudication ◽

Lumbar Stenosis ◽

Lumbar Spinal Canal Stenosis ◽

Nerve Roots ◽

Canal Stenosis ◽

Lumbar Spinal ◽

Sacral Radiculopathy

ABSTRACTLumbar stenosis is a common disorder, usually characterized clinically by neurogenic claudication with or without lumbar/sacral radiculopathy corresponding to the level of stenosis. We present a case of lumbar stenosis manifesting as a multilevel radiculopathy inferior to the nerve roots at the level of the stenosis. A 55-year-old gentleman presented with bilateral lower extremity pain with neurogenic claudication in an L5/S1 distribution (posterior thigh, calf, into the foot) concomitant with dorsiflexion and plantarflexion weakness. Imaging revealed grade I spondylolisthesis of L3 on L4 with severe spinal canal stenosis at L3-L4, mild left L4-L5 disc herniation, no stenosis at L5-S1, and no instability. EMG revealed active and chronic L5 and S1 radiculopathy. The patient underwent bilateral L3-L4 hemilaminotomy with left L4-L5 microdiscectomy for treatment of his L3-L4 stenosis. Postoperatively, he exhibited significant improvement in dorsiflexion and plantarflexion. The L5-S1 level was not involved in the operative decompression. Patients with radiculopathy and normal imaging at the level corresponding to the radiculopathy should not be ruled out for operative intervention should they have imaging evidence of lumbar stenosis superior to the expected affected level.

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