Lumbar Spinal Stenosis

Amundsen, Tom; Weber, Henrik; Lilleås, Finn; Nordal, H. J.; Abdelnoor, Michael; Magnaes, B

doi:10.1097/00007632-199505150-00013

Cited by 350 publications

(35 citation statements)

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“…In comparison, other series have reported it with variable frequency ranging from 23 to 94% [7, 9, 10, 11, 12, 13, 20]probably reflecting differing patient selection and definition of spinal claudication. A series reporting spinal claudication in only 23% of patients also reported leg pain in 58% but did not elaborate further on its nature [7].…”

Section: Discussionmentioning

confidence: 80%

“…Degenerative changes of the lumbar spine are common in the elderly and radiological stenosis of the lumbar spinal canal has been demonstrated in asymptomatic individuals [16, 17]. Furthermore, the association between the degree of radiological narrowing and nature and severity of clinical symptoms has been unclear [10, 13]. This study defines the clinical spectrum of radiological lumbar stenosis in an unselected series of patients.…”

Section: Introductionmentioning

confidence: 99%

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The Clinical Syndrome Associated with Lumbar Spinal Stenosis

Goh¹,

Khalifa

Anslow

et al. 2004

Eur Neurol

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Lumbar spinal stenosis is well defined in patho-anatomical terms but its clinical features are heterogeneous. We carried out a comprehensive retrospective review of the clinical features, radiological changes and outcome of 75 patients with radiologically diagnosed lumbar spinal stenosis in order to define its clinical spectrum. The presenting complaints were of weakness, numbness/tingling, radicular pain and neurogenic claudication in almost equal proportions. The commonest symptom was numbness or tingling of the legs. Neurogenic claudication eventually occurred in only 61%. Ninety-three per cent showed abnormalities on neurological examination, but these were generally mild with reduced ankle jerks being commonest. Imaging of the lumbar spine showed that moderate to severe central spinal stenosis correlated with complaints of weakness and abnormal motor power on clinical examination. Patients were reviewed at a mean of 4 years after diagnosis and 65% had undergone surgical decompression; this was not a prospective comparison of different treatment modalities. Overall, a third of patients felt that their symptoms had improved while a quarter felt that they had worsened. More than half had satisfactory neurological function at the time of review. Thirty-nine per cent of those treated surgically, and 25% of those managed conservatively, reported improved symptoms. A poorer functional status at review correlated with complaints of motor weakness and associated comorbid disease. Degenerative lumbar stenosis is a clinically heterogeneous neurological disorder of the lower limbs in the elderly with variable longer-term outcome. A high index of suspicion is required and neuroimaging should be obtained to confirm the diagnosis.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

The Clinical Syndrome Associated with Lumbar Spinal Stenosis

Goh¹,

Khalifa

Anslow

et al. 2004

Eur Neurol

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“…Therefore, there is a measureable difference in gait variability of healthy subjects and LSS subjects. The gait irregularity is attributed to the low walking tolerance and radicular pain, which are common clinical symptoms in LSS patients (Stucki et al 1994, Turner et al 1992, Rausching 1993, Amundsen et al 1995. More specifically, the low walking tolerance and radicular pain compel the subject to compensate by adjusting the gait pattern.…”

Section: Oswestry and Differential Entropy Correlationmentioning

confidence: 99%

“…It has been reported that walking tolerance (i.e. the ability to endure the stresses of normal walking) can become substantially limited because of neurogenic claudication (Rausching 1993, Amundsen et al 1995. The general hypothesis is that a person with a gait-affecting pathology will exhibit disruptions in his normal gait patterns, when subjected to unexpected discomfort/pain.…”

Section: Introductionmentioning

confidence: 99%

Gait variability measurements in lumbar spinal stenosis patients: part A. Comparison with healthy subjects

Papadakis¹,

Christakis²,

Tzagarakis³

et al. 2009

Physiol. Meas.

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The objective of this study is to compare the gait variability of patients with lumbar spinal stenosis (experimental group) with healthy individuals (control group). The hypothesis is that the preoperative gait variability of the experimental group is higher than the control group. The experimental group consisted of 35 adults (18 males, 17 females). The subjects of the experimental group suffered exclusively from spinal stenosis. The patients were determined by MRI scans. A tri-axial accelerometer sensor was used for the gait measurement, and differential entropy algorithm was used to quantify the gait acceleration signal. The Oswestry Low Back Pain Questionnaire was used to determine the condition on the day of the measurement. Receiver operating characteristic (ROC) was utilized to assess the diagnostic value of the method and determine a cut-off value. There is a statistically significant difference between gait variability in the control group and the experimental group. ROC analysis determines a cut-off differential entropy value. The cut-off value has a 97.6% probability of separating patients with spinal stenosis from healthy subjects. The Oswestry Low Back Questionnaire is well correlated with the spectral differential entropy values.

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“…Degenerative stenosis most often occurs in older individuals, especially in those 50–60 years of age [2–4]. Developmental spinal stenosis is a condition in which the narrow spinal canal is caused by growth disturbance of the posterior elements in the spinal canal [5]. Patients with the congenital type usually complain early in life.…”

Section: Introductionmentioning

confidence: 99%

Transforaminal endoscopic surgery for lumbar stenosis: a systematic review

et al. 2010

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Transforaminal endoscopic techniques have become increasingly popular in surgery of patients with lumbar stenosis. The literature has not yet been systematically reviewed. A comprehensive systematic literature review up to November 2009 to assess the effectiveness of transforaminal endoscopic surgery in patients with symptomatic lumbar stenosis was made. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality, and relevant data, including outcomes, were extracted by two reviewers independently. No randomized controlled trials were identified, but seven observational studies. The studies were of poor methodological quality and heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures. Overall, 69–83% reported the outcome as satisfactory and a complication rate of 0–8.3%. The reported re-operation rate varied from 0 to 20%. At present, there is no valid evidence from randomized controlled trials on the effectiveness of transforaminal endoscopic surgery for lumbar stenosis. Randomized controlled trials comparing transforaminal endoscopic surgery with other surgical techniques are direly needed.

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Lumbar Spinal Stenosis

Cited by 350 publications

References 0 publications

The Clinical Syndrome Associated with Lumbar Spinal Stenosis

The Clinical Syndrome Associated with Lumbar Spinal Stenosis

Gait variability measurements in lumbar spinal stenosis patients: part A. Comparison with healthy subjects

Transforaminal endoscopic surgery for lumbar stenosis: a systematic review

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