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 c...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
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| Series: | Revista Brasileira de Ortopedia |
| Subjects: | |
| Online Access: | http://www.scielo.br/pdf/rbort/v56n1/1982-4378-rbort-56-01-0009.pdf |
| _version_ | 1827295040995590144 |
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| author | Sergio Hennemann Marcelo Rodrigues de Abreu |
| author_facet | Sergio Hennemann Marcelo Rodrigues de Abreu |
| author_sort | Sergio Hennemann |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T07:56:58Z |
| format | Article |
| id | doaj.art-a573055131954818bb51e3d6b39b8ad1 |
| institution | Directory Open Access Journal |
| issn | 1982-4378 |
| language | English |
| last_indexed | 2024-04-24T14:14:11Z |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Ortopedia |
| spelling | doaj.art-a573055131954818bb51e3d6b39b8ad12024-04-03T08:57:22ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-437810.1055/s-0040-1712490Degenerative Lumbar Spinal StenosisSergio HennemannMarcelo Rodrigues de AbreuAbstract 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.http://www.scielo.br/pdf/rbort/v56n1/1982-4378-rbort-56-01-0009.pdfarthrodesisintermittent claudicationdecompressionstenosislow back pain |
| spellingShingle | Sergio Hennemann Marcelo Rodrigues de Abreu Degenerative Lumbar Spinal Stenosis Revista Brasileira de Ortopedia arthrodesis intermittent claudication decompression stenosis low back pain |
| title | Degenerative Lumbar Spinal Stenosis |
| title_full | Degenerative Lumbar Spinal Stenosis |
| title_fullStr | Degenerative Lumbar Spinal Stenosis |
| title_full_unstemmed | Degenerative Lumbar Spinal Stenosis |
| title_short | Degenerative Lumbar Spinal Stenosis |
| title_sort | degenerative lumbar spinal stenosis |
| topic | arthrodesis intermittent claudication decompression stenosis low back pain |
| url | http://www.scielo.br/pdf/rbort/v56n1/1982-4378-rbort-56-01-0009.pdf |
| work_keys_str_mv | AT sergiohennemann degenerativelumbarspinalstenosis AT marcelorodriguesdeabreu degenerativelumbarspinalstenosis |