[Lumbar Spinal Stenosis]

Overview

Journal Orthopadie (Heidelb)

Specialty Orthopedics

Date 2022 Sep 9

PMID 36083346

Authors

Christof Birkenmaier

Manuel Fuetsch

Affiliations

Soon will be listed here.

Abstract

Lumbar spinal stenosis (LSS) represents a frequent degenerative condition, however, striking a clear correlation between typical symptoms and imaging features remains a challenge. Reasons are a high prevalence of radiological LSS in the older population, a considerable percentage of asymptomatic LSS and the existence of differential diagnoses with similar symptomatology. This discrepancy also affects the outcomes - especially of surgically treated patients with LSS. When considering surgical decompression of LSS, the decision with regards to additive instrumentation and/or fusion remains a controversial point of discussion, in particular at the presence of degenerative spondylolisthesis. Recent, well-designed studies, however, clearly point towards a non-inferiority of decompression alone as opposed to the more invasive strategies.

References

Yabuki S, Fukumori N, Takegami M, Onishi Y, Otani K, Sekiguchi M . Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study. J Orthop Sci. 2013; 18(6):893-900. PMC: 3838585. DOI: 10.1007/s00776-013-0455-5. View

Jensen R, Jensen T, Koes B, Hartvigsen J . Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis. Eur Spine J. 2020; 29(9):2143-2163. DOI: 10.1007/s00586-020-06339-1. View

Tomkins-Lane C, Melloh M, Lurie J, Smuck M, Battie M, Freeman B . ISSLS Prize Winner: Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study. Spine (Phila Pa 1976). 2016; 41(15):1239-1246. PMC: 4966995. DOI: 10.1097/BRS.0000000000001476. View

Ohtori S, Yamashita M, Murata Y, Eguchi Y, Aoki Y, Ataka H . Incidence of nocturnal leg cramps in patients with lumbar spinal stenosis before and after conservative and surgical treatment. Yonsei Med J. 2014; 55(3):779-84. PMC: 3990082. DOI: 10.3349/ymj.2014.55.3.779. View

Lai M, Cheung P, Samartzis D, Cheung J . Prevalence and Definition of Multilevel Lumbar Developmental Spinal Stenosis. Global Spine J. 2020; 12(6):1084-1090. PMC: 9210236. DOI: 10.1177/2192568220975384. View

Ferreira Mota Colares S, Colares G, de Carvalho J, Rodrigues C . High Prevalence of Metabolic Syndrome in Patients with Lumbar Spinal Stenosis: Association with Diabetes and Elevated Body Mass Index. Isr Med Assoc J. 2021; 23(12):766-772. View

Han M, Lee D, Park K, Lee Y, Kim K, Sung J . Risk factors and incidence for peripheral arterial disease in patients with typical lumbar spinal stenosis. Korean J Spine. 2014; 11(3):183-7. PMC: 4206957. DOI: 10.14245/kjs.2014.11.3.183. View

Papavero L, Ebert S, Marques C . The prevalence of redundant nerve roots in patients with lumbar spinal stenosis is body position dependent: a retrospective observational study with repeated measures design in an upright MRI scanner. Neuroradiology. 2020; 62(8):979-985. PMC: 7366595. DOI: 10.1007/s00234-020-02423-x. View

Zhou Z, Jin Z, Zhang P, Shan B, Zhou Z, Zhang Y . Correlation Between Dural Sac Size in Dynamic Magnetic Resonance Imaging and Clinical Symptoms in Patients with Lumbar Spinal Stenosis. World Neurosurg. 2019; 134:e866-e873. DOI: 10.1016/j.wneu.2019.11.011. View

10.

Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith F . Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976). 2010; 35(21):1919-24. DOI: 10.1097/BRS.0b013e3181d359bd. View

11.

Barz C, Melloh M, Staub L, Lord S, Merk H, Barz T . Reversibility of nerve root sedimentation sign in lumbar spinal stenosis patients after decompression surgery. Eur Spine J. 2017; 26(10):2573-2580. DOI: 10.1007/s00586-017-4962-5. View

12.

Barz T, Melloh M, Staub L, Lord S, Lange J, Roder C . Nerve root sedimentation sign: evaluation of a new radiological sign in lumbar spinal stenosis. Spine (Phila Pa 1976). 2010; 35(8):892-7. DOI: 10.1097/BRS.0b013e3181c7cf4b. View

13.

Barz T, Staub L, Melloh M, Hamann G, Lord S, Chatfield M . Clinical validity of the nerve root sedimentation sign in patients with suspected lumbar spinal stenosis. Spine J. 2013; 14(4):667-74. DOI: 10.1016/j.spinee.2013.06.105. View

14.

Ko S . Correlations between sedimentation sign, dural sac cross-sectional area, and clinical symptoms of degenerative lumbar spinal stenosis. Eur Spine J. 2017; 27(7):1623-1628. DOI: 10.1007/s00586-017-5374-2. View

15.

Tomkins-Lane C, Quint D, Gabriel S, Melloh M, Haig A . Nerve root sedimentation sign for the diagnosis of lumbar spinal stenosis: reliability, sensitivity, and specificity. Spine (Phila Pa 1976). 2013; 38(24):E1554-60. PMC: 3830734. DOI: 10.1097/BRS.0b013e3182a8c2da. View

16.

Wang G, Peng Z, Li J, Song Z, Wang P . Diagnostic performance of the nerve root sedimentation sign in lumbar spinal stenosis: a systematic review and meta-analysis. Neuroradiology. 2019; 61(10):1111-1121. DOI: 10.1007/s00234-019-02248-3. View

17.

Zhang L, Chen R, Liu B, Zhang W, Zhu Y, Rong L . The nerve root sedimentation sign for differential diagnosis of lumbar spinal stenosis: a retrospective, consecutive cohort study. Eur Spine J. 2016; 26(10):2512-2519. DOI: 10.1007/s00586-016-4435-2. View

18.

Suzuki K, Takatsu T, Inoue H, Teramoto T, Ishida Y, Ohmori K . Redundant nerve roots of the cauda equina caused by lumbar spinal canal stenosis. Spine (Phila Pa 1976). 1992; 17(11):1337-42. DOI: 10.1097/00007632-199211000-00013. View

19.

Tsuji H, Tamaki T, Itoh T, Yamada H, Motoe T, Tatezaki S . Redundant nerve roots in patients with degenerative lumbar spinal stenosis. Spine (Phila Pa 1976). 1985; 10(1):72-82. DOI: 10.1097/00007632-198501000-00012. View

20.

Lee J, Sim K, Kwon H, Kim J, Lee G, Cho S . Effectiveness of lumbar epidural injection in patients with chronic spinal stenosis accompanying redundant nerve roots. Medicine (Baltimore). 2019; 98(9):e14490. PMC: 6831256. DOI: 10.1097/MD.0000000000014490. View