Degenerative Lumbar Spinal Stenosis. When and How Should We Operate On

  • Thomas Patsiaouras Former Director Orthopaedic dpt, Asklipiion Hospital - Voula-Athens
Keywords: Low Back Pain, Stenosis, Intermitted Claudication, Arthrodesis

Abstract

Lumbar Spinal Stenosis is a degenerative spinal condition affecting 50% of patients usually over 50 years.

Is considering the end result of the degenerative cascade with compression of neural tissues by disc displacement anteriorly and by hypertrophy of facet joints and ligamentum flavun posteriorly. The main symptom except Low Back Pain  and sciatica is the Intermitted Claudication. There is no always correlation between clinical symptoms and the degree of stenosis in imaging studies. The natural history of LSS is unpredictable but some patient can be benefitted by the conservative treatment. We have to be aware from Cauda Equina Syndrome which is more insidious in LSS. Treatment options range from conservative to surgical according the degree of stenosis and the severity of clinical symptoms. In this article are described  the surgical techniques for decompression and the indications for concomitant arthrodesis in cases of instability  and deformity.

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Published
2021-04-26