Lumbar spinal stenosis

A.I. Isaykin, O.A. Chernenko, A.I. Rosen

Sechenov University, Moscow

Lumbar spinal stenosis (LSS) is a narrowing of the central spinal canal (central stenosis) or lateral recess and intervertebral foramen (lateral stenosis). LSS is one of the most common causes of lumbar pain in the elderly. The clinical picture of this disease consists of local lumbar musculoskeletal pain and claudication — radicular symptoms that occur during walking. LSS diagnosis is most likely in elderly patients with claudication during walking and standing, regressed when leaning forward or sitting. The treatment tactics is determined by the clinical picture, rather than changes identified by imaging studies. The most significant diagnostic criterion is the walking distance. Therapeutic strategies for patients with LSS are not fully defined because there is insufficient evidence of different treatment options effectiveness. They usually begin with multidisciplinary conservative therapy, including lifestyle recommendations, psycholo gical techniques, exercise therapy, prescription of drugs (including NSAIDs), as well as epidural administration of glucocorticoids and local anaesthetics. If conservative therapy is ineffective, the possibility of neurosurgical intervention is discussed, sometimes in combination with the use of fixing systems. The application results of different neurosurgical intervention options are ambiguous.

Keywords: lumbar spinal stenosis, lumbosacral instability, stenosis surgical treatment with the imposition of the stabilizing systems.

For citation: Isaykin A.I., Chernenko O.A., Rosen A.I. Lumbar spinal stenosis. RMJ. 2019;9:40–43.