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The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis ...
Weight loss, to relieve symptoms and slow the progression of the stenosis; Physical therapy to support self-care. [37] Also may give instructions on stretching and strength exercises that may lead to a decrease in pain and other symptoms. Lumbar epidural steroid or anesthetic injections have low quality evidence to support their use. [36] [38]
These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal.
Degenerative spondylolisthesis at L5-S1. (A) CT sagittal view of a low grade slip. (B) Lateral radiograph pre-operative intervention. (C) Surgically treated with L5–S1 decompression, instrumented fusion and placement of an interbody graft between L5 and S1. Both minimally invasive and open surgical techniques are used to treat anterolisthesis ...
Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis.
In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence. [3] In the cervical and thoracic spine it is used to treat myelopathy caused by compression of the spinal cord itself.
The majority of disc herniations occur in the lumbar spine (95% at L4–L5 or L5–S1). [21] The second most common site is the cervical region (C5–C6, C6–C7). The thoracic region accounts for only 1–2% of cases.
MRI of the lumbar spine showing spinal stenosis. Neurogenic claudication is one subtype of the clinical syndrome of lumbar spinal stenosis (LSS). [9] No gold standard diagnostic criteria currently exist, but evaluation and diagnosis is generally based on the patient history, physical exam, and medical imaging. [1]
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