Spinal Stenosis
Abstract
- Spinal stenosis is defined as diminition in the size of the spinal canal that produces nerve entrapment resulting in symptoms, the most common of which is low back pain & radiating pain to leg. The central spinal canal contains the dura and other meninges, and inside these, the nerves of the cauda equina. The nerve root canal contains the spinal nerve from the point which the dura leaves the intervertebral foramina. Each foramen is a door through which the nerve enters to the nerve root canal. In its canal the nerve passes behind the disc and then in front of the superior articular process of the lower vertebra. Pathological and anatomical changes by various cases can produce narrowing of the central and nerve root canal. But they are sometimes not important because they are not severe enough to cause nerve entrapment and such medical treatment, Spinal stenosis is only significant when nerves are entraped, indicated by severe leg pain and sometime by sensory and motor changes. Spinal stenosis is classified into two groups: congenital and acquired. Among acquired groups, the combined type is most common and significant. Authors have experienced 61 cases of spinal stenosis and among these, 58 cases were treated surgically between 1981 and 1984 at the Department of Orthopaedic Surgery, Eulji Glneral Hospital, Daejeon. The following results were obtained. 1. There were 52 males and 33 females, and peak incidence in 5th and 6th decade(69%) 2. The most common type by Arnoldi's etiological classification was combined type(69%) 3. The most common chief complaint on admission was low back pain and radiating pain to leg (43%) 4. The most common sign was limitation of lumbar hyperextension (75.9%) and S.L.R.test was positive in only 12 cases(20.7%). 5. The common findings of myelography were hour glss appearance (39.7%) and complete block (27.6%), and simple radiologic findings were hypertrophy of facet joint, osteophyte formation in the periphery of vertebral bodies involved and narrowing of disc speace. 6. The A-P diameter of spinal canal was between 14.44 mm and 14.97 mm in simple findings, and the A-P diameter of dural sac between 8.10 mm and 9.19 mm in myelography. The spinal index was between 1:4.90 and 1:5.60. 7. Decompressive surgery was done in the 2 levels in 39 cases (67.3%), 3 levels in 10 cases (17.2%) and 1 level in 9 cases (15.5%). Discectomy was done in 40 cases (69%) and partial laminectomy was done in 58 cases (100%). 8. The most common site was L3,4-L4,5 (36.2%).