Lumbar Stenosis: A Recent Update by Review of Literature

Abstract

Degeneration of the intervertebral disc results in initial relative instability, hypermobility, and hypertrophy of the facet joints, particularly at the superior articular process. This finally leads to a reduction of the spinal canal dimensions and compression of the neural elements, which can result in neurogenic intermittent claudication caused by venous congestion and arterial hypertension around nerve roots. Most patients with symptomatic lumbar stenosis had neurogenic intermittent claudication with the risk of a fall. However, although the physical findings and clinical symptoms in lumbar stenosis are not acute, the radiographic findings are comparatively severe. Magnetic resonance imaging is a noninvasive and good method for evaluation of lumbar stenosis. Though there are very few studies pertaining to the natural progression of lumbar spinal stenosis, symptoms of spinal stenosis usually respond favorably to non-operative management. In patients who fail to respond to non-operative management, surgical treatments such as decompression or decompression with spinal fusion are required. Restoration of a normal pelvic tilt after lumbar fusion correlates to a good clinical outcome.

Epidemiological Panorama of Orthopedic Spine Pathology in Mexico

“…The most affected level was L4-L5, with L5-S1 in second place, which corresponds to findings reported in the literature. 12,13,15 We determined that there was no significant increase in the number of cases of spondylolisthesis during the period from 2009 to 2016. Its prevalence is higher in women.…”

“…The most frequently affected level was C6-C7 (60%), followed by C5 -C6 (20%) and C4 -C5. 12,13,15 It is difficult to determine the exact prevalence of lumbar pain as a health issue because only a part of the population with this problem is treated in this unit. However, the international literature suggests that the prevalence of lumbar pain has not changed significantly over that last 30 years.…”

“…[8][9][10][11] They are patients that pose a significant health problem in Mexico due to the fact that they require prolonged hospitalizations, often several surgical procedures, and the recovery period is long, which means more consultations, lost work time, and the employment of relatives as caretakers during their recovery. [12][13][14][15] The objective of our study was to identify the prevalence of orthopedic spine pathology in a national reference center from 2009 to 2016.…”

In Vivo Characteristics of Nondegenerated Adjacent Segment Intervertebral Foramina in Patients With Degenerative Disc Disease During Flexion-Extension

“…Hasegawa et al in a cadaver study described the critical dimension of 4mm or less of posterior disc space height and 15 mm of foraminal height that lead to compression of the nerve root in the foramen. The geometric changes could cause compression of the nerve root in the lower lumbar spine 2 , resulting in lower back pain and lower limb radiculopathy in adults 3 .…”

Management of a Case of Lumbar Stenosis With Ayurvedic Intervention

“…It is diagnosed from history, physical examination, and imaging studies. It is managed with physiotherapy, non-steroidal anti-inflammatory drug (NSAID) medications, and surgical laminectomy in the conventional system of medicine [1,2]. In Ayurveda, from the nature of the disease, it has clinical resemblance with Katigraha and Gridhrasi.…”