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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.
Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.
Pathological processes that can occur in these joints include degenerative changes or hypertrophic arthritis, resulting in foraminal stenosis and nerve compression. Foraminal stenosis at this joint is the most common cause of cervical nerve root pressure. They were characterized by Hubert von Luschka in 1858. [4] [5]
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]
Bertolotti's syndrome is a commonly missed cause of back pain which occurs due to lumbosacral transitional vertebrae (LSTV). It is a congenital condition but is not usually symptomatic until one's later twenties or early thirties. [1] However, there are a few cases of Bertolotti's that become symptomatic at a much earlier age.
This is a result of the vertebral artery becoming occluded as it passes up in the transverse foramen. The spinal joints become stiff in cervical spondylosis. Thus the chondrocytes which maintain the disc become deprived of nutrition and die. Secondary osteophytes may cause stenosis for spinal nerves, manifesting as radiculopathy.
Affected persons usually feel dull pain in the lumbar spine that can radiate into the buttocks and legs. Typically, the pain is worsened by stress on the facet joints, e.g. by lumbar extension and loading (the basis of the Kemp test) or lateral flexion but also by prolonged standing or walking. [citation needed]
Disc herniation and foraminal stenosis are the most common causes of radiculopathy. [11] Imaging of the spine and laboratory tests is not recommended during the acute phase. [19] This assumes that there is no reason to expect that the patient has an underlying problem. [36] [19] In most cases, the pain subsides naturally after several weeks. [36]
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