Benditz A, Grifka J
Orthopädische Klinik für die Universität Regensburg im Asklepios Klinikum Bad Abbach, Universität Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Deutschland.
Orthopade. 2019 Feb;48(2):179-192. doi: 10.1007/s00132-018-03685-3.
The number of patients with the diagnosis of lumbar spinal stenosis (LSS) is steadily increasing and simultaneously, the patients' expectations are also increasing. Nevertheless, evidence from studies for the appropriate treatment is still lacking. Treatment options mainly result from the practitioner 's experience and the clinical focus. The findings described in magnetic resonance imaging (MRI) often do not correlate with the patient's symptoms. Basically, the treatment should be started with a conservative treatment and preferably with a multimodal approach. Severe pain with extensive neurogenic claudication symptoms and unsuccessful conservative treatment should be treated surgically. Absolute indications for surgery, such as a conus-cauda syndrome are rare. The goal of all surgical procedures is to decompress the spinal canal without compromising the stability of the motion segment. Instability can also make an additional fusion necessary.
腰椎管狭窄症(LSS)的诊断患者数量正在稳步增加,与此同时,患者的期望也在提高。然而,关于适当治疗的研究证据仍然不足。治疗方案主要基于从业者的经验和临床重点。磁共振成像(MRI)中描述的结果通常与患者的症状不相关。基本上,治疗应从保守治疗开始,最好采用多模式方法。伴有广泛神经源性间歇性跛行症状的严重疼痛且保守治疗失败的情况应进行手术治疗。手术的绝对指征,如圆锥马尾综合征很少见。所有手术的目标都是在不影响运动节段稳定性的情况下减压椎管。不稳定也可能需要额外进行融合手术。