Klassifikation und Diagnostik der lumbalen Spinalkanalstenose

Arabmotlagh, Mohammad; Sellei, Richard Martin; Vinas-Rios, Juan Manuel; Rauschmann, Michael

doi:10.1007/s00132-019-03746-1

Cited by 13 publications

(4 citation statements)

References 18 publications

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“…Lumbar spinal stenosis (LSS) can cause lumbago and leg pain or lower extremity motor dysfunction in middle-aged and elderly people. The pathogenesis is mainly intervertebral disc bulge, protrusion or degenerative calcification, vertebral joint hyperplasia and ossification, ligamentum flavum hypertrophy, and calcification, which can lead to stenosis of the spinal canal, lateral recess, nerve root canal, or foramina, thus causing a series of symptoms such as compression of cauda equina nerve, blood vessels, and nerve roots in the dural sac or inflammatory reactions [ 1 , 2 ]. Anatomically, there are three distinct forms of LSS: lateral foraminal, recess, and central canal stenosis.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Severity of Lumbar Spinal Stenosis and Ligamentum Flavum Hypertrophy and Serum Inflammatory Factors

Zhao

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This study is aimed at investigating the correlation between lumbar spinal stenosis (LSS) severity, ligamentum flavum hypertrophy, and the upregulation of inflammatory markers. Methods. From March 2019 and May 2022, eighty-five inpatients with LSS were enlisted as the study’s research group, while sixty-five patients hospitalized for lumbar intervertebral disc herniation over the same time period served as the study’s control group. Moreover, mild, moderate, and severe subgroups of patients were created within the research population based on their LSS severity. The ligamentum flavum thickness and the positive expression rates of TNF-α, TGF-β1, and IL-1α were compared between the study group and the control group. The levels of TNF-α, TGF-β1, and IL-1α that were found to be positively expressed were compared between the mild, moderate, and severe groups. Patients with LSS had their ligamentum flavum thickness and their positive expression rates of TNF-α, TGF-β1, and IL-1α analyzed using Spearman correlation analysis. We evaluated the diagnostic utility of the positive expression rates of IL-α1, TGF-β1, and TNF-α and ligamentum flavum thickness in distinguishing the severity of LSS using a receiver operating characteristic (ROC) curve. Results. The rates of both lower limb pain (40.00%) and intermittent claudication (80.00%) in the LSS group were higher than those in the lumbar disc herniation group (15.38%, 12.31%), with statistical significance ( P < 0.05 ). However, no substantial disparity was observed in left lower limb pain, right lower limb pain, low back pain, lower limb sensation, muscle strength, and reflex abnormalities between the two groups ( P > 0.05 ). Positive expressions of TGF-β1, TNF-α, and IL-1α and thicker ligamentum flavum were more prevalent in the LSS group than in the lumbar intervertebral disc herniation group. All indexes were significantly ( P < 0.05 ) higher in the moderate stenosis group than in the severe stenosis group. Additionally, the thickness of the ligamentum flavum and the positive expression rates of TNF-α, TGF-β1, and IL-1α were higher in the mild and moderate stenosis groups than in the severe stenosis group. The expression levels of TNF-α, TGF-β1, and IL-1α were favorably linked with ligamentum flavum thickness ( P < 0.05 ). ROC curve analysis showed that the thickness of ligamentum flavum, the expression of IL-1α, the expression of TGF-β1, and the expression of TNF-α could effectively diagnose mild, moderate, and severe LSS ( P < 0.05 ). Conclusion. Ligamentum flavum hypertrophy and positive expression rates of IL-1α, TGF-β1, and TNF-α are closely linked to LSS, which can effectively identify mild, moderate, and severe LSS.

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Section: Introductionmentioning

confidence: 99%

Relationship between Severity of Lumbar Spinal Stenosis and Ligamentum Flavum Hypertrophy and Serum Inflammatory Factors

Zhao

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Because a series of symptoms including intermittent claudication, sciatica, horsetail, and so on, LSS often causes great trouble on the lives of patients, and seriously influences the patient's quality of life. [ 1 – 4 ]…”

Section: Introductionmentioning

confidence: 99%

Decompression with fusion versus decompression in the treatment of lumbar spinal stenosis

Chen

Wang

et al. 2020

Medicine

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Objective: The goal of this study was to review relevant studies in order to determine the efficacy of decompression with fusion versus decompression in the treatment of lumbar spinal stenosis. Methods: Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through October 2019 were considered for inclusion. For each study, we used odds ratios, mean difference (MD), and 95% confidence interval (95% CI) to assess and synthesize outcomes. Results: We found 13 studies that were consistent with this meta-analysis with a total of 29066 patients. Compared with decompression, decompression with fusion significantly increased the incidence of complications (RR: 1.41, 95%CI: 1.26–1.57), the length of hospital stay (WMD: 1.868, 95%CI: 1.394–2.343), operative time (WMD: 80.399, 95%CI: 44.397–116.401), estimated blood loss (WMD: 309.356, 95%CI: 98.008–520.704) and Zurich claudication questionnaire in symptom severity (WMD: 0.200, 95%CI: 0.006–0.394). The reoperation rate was lower in the decompression with fusion group than the decompression group but without significant difference (RR: 0.91, 95%CI: 0.82–1.00). There was no significant difference between 2 groups in visual analog scale (leg pain and back pain), ODI, Short Form 36 Health Survey physical component summary, Short Form 36 Health Survey mental component summary, and Zurich claudication questionnaire physical function. Conclusion: Decompression with fusion has no significant clinical advantages in treatment of lumbar spinal stenosis when compared with decompression.

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“…Thoracic spinal stenosis is a rare entity for which the incidence is unknown (12). Spinal stenosis can be classified etiologically into two categories: congenital and acquired (13). Most patients will have acquired canal stenosis, often due to degenerative causes, systemic illness or postsurgical pathology (2).…”

Section: Discussionmentioning

confidence: 99%

Case report: Thoracolumbar spinal stenosis associated with alkaptonuria

et al. 2023

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BackgroundAlkaptonuria is a rare autosomal genetic disorder with an incidence of about 1 in 1 million per year. Spinal involvement often manifests in the later stages of the disease. However, this is the first report of the presentation of thoracolumbar spinal stenosis.Case presentationWe report the case of a 61-year-old female patient with significant thoracolumbar stenosis symptoms. The patient had obvious kyphosis with preoperative lower extremity muscle strength grade 2/5. Symptoms and imaging signs initially suggested ankylosing spondylitis. This patient was classified into motor incomplete injury (ASIA C). However, the patient was found to have melanin deposits on the sclera and skin, and the urine was darkened at rest. CT and MRI both suggested no bone bridge connection between vertebrae, which was the key difference between ankylosing spondylitis and alkaptonuria in imaging. Most importantly, urine specimen testing and intraoperative pathology demonstrated alkaptonuria. The patient underwent spinal decompression and vertebral body fixation. Postoperative recovery was good: the patient had significantly relieved pain and could stand and walk.ConclusionThis case is the first report of thoracolumbar spinal stenosis associated with alkaptonuria involving the spine.

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Klassifikation und Diagnostik der lumbalen Spinalkanalstenose

Cited by 13 publications

References 18 publications

Relationship between Severity of Lumbar Spinal Stenosis and Ligamentum Flavum Hypertrophy and Serum Inflammatory Factors

Relationship between Severity of Lumbar Spinal Stenosis and Ligamentum Flavum Hypertrophy and Serum Inflammatory Factors

Decompression with fusion versus decompression in the treatment of lumbar spinal stenosis

Case report: Thoracolumbar spinal stenosis associated with alkaptonuria

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