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KMID : 0614520060160010010
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Journal of the Korean Pain Research Society
2006 Volume.16 No. 1 p.10 ~ p.15
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Update on Treatment of Spinal Stenosis
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Park Jung-Yul
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Abstract
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Sumbar spinal stenosis can be caused by various disorders, both congenitally and secondarily. Most of spinal stenosis seen clinically are with with lumbar spinal stenosis. It results from hypertropyhy or enlargement of bony structures, ligament, and other surrounding tissues and cause characteristic clinical symptoms and signs such as radiculopathy and intermittent neurogenic claudication. The pathophysiologic mechanisms associated with these symptoms are arterial insufficiency, venous congestion, inflammatory response, biomechanical factors, and segmental spinal instability. The natural course of patients with lumbar spinal stenosis varies, but usually 15∼30% of patients stabilizes or improves with conservative treatment, 30∼45% become aggravated over the several years, and about 30∼45% eventually require some forms of surgery. However, there are well known predictive factors how these patients progress over the time. Thus, appropriate treatment option and timing should be carefully decided according to the clinical settings. For this, treating physician should be aware of anatomy and pathophysiology of lumbar spinal stenosis with regards to various changes taking place in each individual. With these in background careful search for the appropriate managements with optimal timing should then be decided. This review is to provide the standards of the treatment of lumbar spinal stenosis along with the introduction of updated knowledge based on recent publications.
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KEYWORD
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Spinal stenosis, , Lumbar, Pathophysiology, Update, Treatment
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