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|All Authors / Contributors:||
Dejan Kupnik; Tomaž Brodnik; Lidija Praper
|Other Titles:||Lumbar spinal stenosis|
|Responsibility:||Dejan Kupnik, Tomaž Brodnik, Lidija Praper.|
Lumbar spine stenosis is characterized by narrowing of the spinal canal, lateral recesus or intervertebral foramen in the lumbar part of the spine with possible compression of the spine or nerve roots, and presents as a pseudoclaudication or a radiculopathy. Most patients are aged over 50 years. Lumbar spine stenosis can be congenital or aquired. The first appears earlier in life and has less spinal degenerative changes, later appears in life and is characterized with more prominent spinal degenerative features. Symptoms comprise of neurogenic claudication or pseudoclaudication in central stenosis, and radicular pain and other symptoms in stenosis of lateral recessus. Patients usually complain of insidious onset of low back pain with progression to buttocks and legs over the course of weeks or months. The symptoms tipically worsen in erect standing position, while bending forward, walking uphill, cycling or squatting brings relief. It is important to distinguish between claudication due to peripheral artery disease and neurogenic claudication. Therapy consists of conservative measures or surgical decompression of neural tissue. The later is reserved for patients who fail to respond to conservative treatment and those with worse initial symptoms. The goal of treatment is to relieve the symptoms and to resume daily working and other activities as soon as possible.