Arthritis and Back Pain Center and Osteoporosis Prevention and Treatment Center, Inc., Swezey Institute, Santa Monica, California.
J Clin Rheumatol. 1996 Jun;2(3):129-34. doi: 10.1097/00124743-199606000-00004.
To document the natural history and outcomes of lumbar spinal stenosis in patients with neurogenic claudication, 47 patients who had been evaluated 5 years earlier were evaluated by telephone interview. Thirty-one were reexamined. The average duration of symptoms was 8 years. All patients had bilateral lower extremity symptoms, which were more pronounced unilaterally in three patients.Of the nonsurgically treated cases, 43% (20/47) improved; 30% (14/47) were unchanged. Seven of 11 patients treated with intermittent traction 1-2 times weekly improved walking tolerance and reported less back pain. Eight of 13 improved their walking tolerance after 1-3 epidural cortico-steroid injections. The 23% (11/47) who did not improve or worsened reported improvement after laminectomy.The majority of patients with symptomatic spinal stenosis will stabilize or improve without surgery. For those with intolerable symptoms, laminectomy can usually provide appreciable symptomatic relief.
为了记录伴有神经源性跛行的腰椎管狭窄症患者的自然病史和结局，对 47 名在 5 年前接受过评估的患者进行了电话访谈。其中 31 名患者接受了重新检查。症状平均持续 8 年。所有患者均有双侧下肢症状，3 名患者单侧症状更为明显。在非手术治疗的病例中，43%（20/47）有所改善；30%（14/47）无变化。每周接受 1-2 次间歇性牵引治疗的 11 例患者中，7 例行走耐力改善，报告背痛减轻。13 例接受 1-3 次硬膜外皮质类固醇注射治疗的患者中，8 例行走耐力改善。11 例未改善或恶化的患者在接受椎板切除术治疗后报告有所改善。大多数有症状的椎管狭窄症患者无需手术即可稳定或改善。对于那些有难以忍受的症状的患者，椎板切除术通常可以提供明显的症状缓解。
