Lumbar Spinal Stenosis
The spinal canal runs through the vertebrae and, in the lower (or lumbar) spine, contains the nerves supplying sensation and strength to the legs. The characteristic syndrome associated with lumbar stenosis is termed neurogenic intermittent claudication If the stenosis is located on the lower part of the spinal cord it is called lumbar spinal stenosis . The problem usually causes back pain and leg pain that comes and goes with activities such as walking. These changes cause narrowing of the lumbar spinal canal which is known as spinal stenosis (figure). Over time, it narrows the diameter of the hose, just as spinal stenosis narrows the spinal canal.
Understanding the anatomy of the lumbar spine is critical to appreciating the various causes and treatment of lumbar spinal stenosis. The lumbosacral spine includes the five vertebral bodies L-1 to L-5, the sacrum, the intervertebral discs, the ligamentum flavum, and the spinal cord and cauda equina. Spinal stenosis occurs when there is impingement of the spinal cord, cauda equina, or the exiting nerve roots from the structures surrounding them. Most commonly, the impingement is multifactorial, including enlargement of the bony structure surrounding the canal, hypertrophy of the ligamentum flavum, and bulging of the intervertebral discs.
Causes of Lumbar Spinal Stenosis
Careful attention to the patient's history and physical examination is essential to make the diagnosis of lumbar spinal stenosis. Radiographic studies alone are insufficient to make the diagnosis because asymptomatic degenerative findings are often present on diagnostic imaging, particularly in older adults. Age at initial presentation varies depending on whether there is underlying developmental stenosis. Patients with developmental stenosis generally become symptomatic in their third through fifth decades of life, whereas patients with degenerative stenosis become symptomatic in the sixth through eighth decades of life. Here are the list of the possible causes of Lumbar Spinal Stenosis :
Symptoms of Lumbar Spinal Stenosis
Patients with symptomatic lumbar spinal stenosis classically present with the syndrome of neurogenic pseudoclaudication. This syndrome consists of complaints of buttock, thigh, and calf pain exacerbated with walking, standing, or lumbar extension and alleviated with sitting, lying, or lumbar flexion. Although calf pain is considered part of this clinical constellation, studies have demonstrated that calf pain can be present in as little as 56% of patients.
Conclusion and SUmmary: Lumbar spinal stenosis is a clinical diagnosis made on the basis of the patient's history, physical exam, and diagnostic imaging studies. Similarly, treatment must be based not only on the "hard facts" of MRI but also on the patient's preferences and expectations and mental and physical capabilities. More data are needed to help us make better decisions about which patients are best served by surgery (and what type) and which are best served by conservative therapy.
Some sign and symptoms related to Lumbaal Stenosis :
Treatment of Lumbar Spinal Stenosis
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