Birkenmaier Christof, Fuetsch Manuel
Wirbelsäulenchirurgie & Skoliosezentrum, Artemed Klinikum München Süd, Am Isarkanal 30, 81379, München, Deutschland.
Neurochirurgische Klinik und Poliklinik, LMU Klinikum, Marchioninistr. 15, 81377, München, Deutschland.
Orthopadie (Heidelb). 2022 Nov;51(11):943-952. doi: 10.1007/s00132-022-04297-8. Epub 2022 Sep 9.
Lumbar spinal stenosis (LSS) represents a frequent degenerative condition, however, striking a clear correlation between typical symptoms and imaging features remains a challenge. Reasons are a high prevalence of radiological LSS in the older population, a considerable percentage of asymptomatic LSS and the existence of differential diagnoses with similar symptomatology. This discrepancy also affects the outcomes - especially of surgically treated patients with LSS. When considering surgical decompression of LSS, the decision with regards to additive instrumentation and/or fusion remains a controversial point of discussion, in particular at the presence of degenerative spondylolisthesis. Recent, well-designed studies, however, clearly point towards a non-inferiority of decompression alone as opposed to the more invasive strategies.
腰椎管狭窄症（LSS）是一种常见的退行性疾病，然而，要在典型症状和影像学特征之间建立明确的关联仍然具有挑战性。原因包括老年人群中放射学腰椎管狭窄症的高患病率、相当比例的无症状腰椎管狭窄症以及存在具有相似症状的鉴别诊断。这种差异也影响了治疗结果，尤其是接受手术治疗的腰椎管狭窄症患者。在考虑对腰椎管狭窄症进行手术减压时，关于是否附加内固定和/或融合的决策仍然是一个有争议的讨论点，特别是在存在退行性椎体滑脱的情况下。然而，最近设计良好的研究明确表明，与更具侵入性的策略相比，单纯减压并不逊色。
