Lumbar spinal stenosis is actually a very common spinal surgical condition, but despite being very common, the average patient has little or no knowledge of the disease, and there are even many misconceptions about it. Lumbar spinal stenosis is one of the common causes of low back pain or back and leg pain, mostly seen in middle-aged and elderly people. Expert interpretation: Many people attribute lumbar and leg pain in middle-aged and elderly people to lumbar disc herniation, but in fact the more common cause of lumbar and leg pain in middle-aged and elderly people is lumbar spinal stenosis, the similarity between the two is that both belong to degenerative disease of the intervertebral disc, the difference is that lumbar disc herniation is only a bad disc, the other structures of the spine are basically normal; while lumbar spinal stenosis is with the growth of age, the accumulation of time, in On the other hand, lumbar spinal stenosis is a problem caused by a combination of factors, such as the degeneration of the intervertebral discs, hyperplasia and coalescence of the small joints, the formation of bone redundancy at the posterior edge of the vertebral body, and the hypertrophy and thickening of the fibrous tissues of the ligamentum flavum and the posterior longitudinal ligament, etc. These hard and soft factors cause the narrowing of the spinal canal in general, thus causing compression of the nerve roots and cauda equina. Lumbar spinal stenosis is a group of chronic progressive disorders of the spinal cord and spinal nerve roots. Usually lumbar spinal stenosis includes three components, namely the main spinal canal, the neural spinal canal and intervertebral foraminal stenosis. Any narrowing of the lumbar spinal canal or nerve roots or intervertebral foramen due to osteophytes or hypertrophy of fibrous tissue from various causes, resulting in cauda equina or nerve root compression and symptoms, is considered lumbar spinal stenosis. Expert interpretation: The two definite terms chronic and progressive here point out the characteristics of the natural history of lumbar spinal stenosis. The first is chronic, it is a chronic disease, it is the result of accumulation year by year, reminding us that we should take care of the spine from a young age and pay attention to spinal health, another aspect also tells us that this disease needs long-term treatment, especially lifestyle intervention, as in the case of hypertension, we cannot cure hypertension by seeing a doctor once and taking some medicine, this reasoning is also suitable for lumbar spinal stenosis and other The same applies to chronic skeletal muscle diseases such as lumbar spinal stenosis. Progressive means that the disease will gradually worsen, and once the spinal stenosis reaches a certain level and the body’s compensatory capacity reaches its limit, obvious clinical symptoms will appear, at which point conservative treatment will be unsuccessful and surgery will need to be considered, which is different from medical diseases such as hypertension. There are two types of lumbar spinal stenosis: primary and secondary. Primary lumbar spinal stenosis, also known as congenital spinal stenosis, is caused by dysplasia during growth and development and includes the spinal roots.
It is caused by the developmental defects, including the short arch root, the short spacing between the arch root on both sides, the so-called small joints on both sides close to the center, the hypertrophy of the vertebral plate, the hypertrophy or variation of the posterior edge of the vertebral body or small joints, etc. Secondary lumbar spinal stenosis is caused by acquired factors, including hypertrophy and laxity of the ligamentum flavum, disc herniation, vertebral body dislocation, osteophytes of the superior articular eminence and the posterior edge of the vertebral body, etc. Expert interpretation: Because there are some people who have congenital developmental factors present, their own spinal canal development is relatively narrow, so in the presence of mild acquired degenerative factors such as disc herniation, thickening of the ligaments, osteophytes at the posterior edge of the vertebral body, and hyperplastic coalescence of the articular eminence, etc., it can cause significant nerve compression. Therefore, although lumbar spinal stenosis is mostly seen in middle-aged and elderly people, in some patients with developmental spinal stenosis, its onset age can be advanced, and it can come out in the 30s and 40s.