Definition.
A narrowing of the lumbar spinal canal in one or more planes due to bony or fibrous hyperplasia and displacement, which produces clinical symptoms by compressing the cauda equina or nerve roots, is called spinal stenosis.
Diagnostic criteria.
I. Symptoms.
1. Most often seen in middle-aged and elderly patients over 40 years of age.
2. History of chronic low back pain.
3. The severity of symptoms is related to posture, and is aggravated by posterior extension of the spine.
4, Neurogenic intermittent claudication.
II. Signs.
1, Most of them have no obvious signs.
2. The straight leg raise test is negative, but numbness and soreness of the lower extremities may occur over time.
3. Continuous compression may cause abnormal sensation and muscle strength in the affected innervation area, and even dysfunction.
4. Signs of lateral saphenous fossa and nerve root canal stenosis are similar to those of unilateral disc herniation.
Third, imaging examination.
1.X-ray film of the transverse diameter of the spinal canal <18mm; sagittal diameter <13mm can be considered spinal stenosis.
2, CT measurement of the product of the sagittal diameter of the vertebral foramen and the transverse diameter of the same vertebral body and the ratio of the two > 1:4.5 can be considered spinal stenosis.
3.Vertebral canal imaging may show complete or partial obstruction, shortening, fading, distortion, indentation, and non-distribution of nerve roots.
4. MRI shows signs of stenosis and compression of the spinal canal, lateral saphenous fossa, and nerve root canal.
Treatment methods.
1.Non-surgical treatment.
(1) Bed rest.
(2) Intravenous treatment of blood circulation and blood stasis, swelling and pain relief, and neurotrophic drugs.
(3) Local physical therapy, introduction, warming and meridians.
(4) Pelvic traction, usually starting from 13-15 kg. Increase the weight after no discomfort.
(5) Lumbar spine manipulation.
(6) Chinese medicine identification, internal and external use of Chinese medicine.
2.Surgical treatment.
(1) total laminectomy decompression, internal fixation and bone graft fusion.
(2) Half laminectomy and decompression.
(3) Expanded interlaminar opening.