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Low back pain accounts for 17% of all physician visits of people aged 65 and older. [37] From this population, a large portion of radicular pain stems not from disk pathology, but from lumbar spinal stenosis. [37] According to Kalff et al., 21% of people over the age of 60 have lumbar spinal stenosis, as confirmed by radiological screening. [38]
Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
Specifically, local muscles that attach directly to the spine are affected. The lumbar multifidus and transversus abdominis play a direct role in stabilizing the lumbar spine. Instead the local muscles in individuals with spondylolysis are vulnerable to dysfunction, which results in abnormal spinal stability causing chronic low back pain.
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.
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]
Because each vertebra can cause pain in different areas of the body, the pain from the disease can be sensed in the back, leg, neck area, or even the arms. When the spinal canal begins to lose its gap and gets thinner, it can cause pain in the neck, which can also cause a numb feeling in the arms and hands.
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