Goldman S M, Funk J D, Christensen V M
J Am Podiatr Med Assoc. 1997 Mar;87(3):117-24. doi: 10.7547/87507315-87-3-117.
Spinal stenosis, involving pressure on either the central spinal cord or nerve root exiting the spinal canal, can cause a variety of symptoms in the lower extremities. A classic symptom is that of neurogenic claudication, involving leg pain and weakness brought on by walking. The pain is relieved by sitting or lying down, not by standing and resting as would be seen in arterial insufficiency-induced claudication. Other symptoms of spinal stenosis can involve paresthesia, weakness or cramping in one or both extremities, rest pain, or burning pain, and are commonly misdiagnosed as peripheral neuropathy, especially in patients with diabetes. Symptoms are often chronic, frequently missed, or misdiagnosed in the medical community, and may cause severe disability or reduction in the quality of life. Spinal stenosis is in some patients the unidentified cause of failure of treatment of foot and leg pain. Podiatric physicians, who focus on the patient's lower extremities, are in a unique position to be able to identify spinal stenosis and facilitate appropriate treatment. The authors provide current information regarding symptoms of spinal stenosis, a guide to diagnosis including the anatomical etiologies, and a basic understanding of treatment.
椎管狭窄是指脊髓中央或从椎管穿出的神经根受到压迫，可导致下肢出现多种症状。一个典型症状是神经源性间歇性跛行，即行走时出现腿痛和乏力。疼痛通过坐下或躺下缓解，而非像动脉供血不足引起的间歇性跛行那样通过站立休息缓解。椎管狭窄的其他症状可能包括一个或双下肢的感觉异常、乏力或痉挛、静息痛或灼痛，这些症状常被误诊为周围神经病变，尤其是在糖尿病患者中。症状往往是慢性的，在医学界常常被漏诊或误诊，可能导致严重残疾或生活质量下降。在一些患者中，椎管狭窄是足腿痛治疗失败的未被识别的原因。专注于患者下肢疾病的足病医生，在识别椎管狭窄并促进适当治疗方面具有独特优势。作者提供了有关椎管狭窄症状的最新信息、包括解剖学病因的诊断指南以及对治疗的基本认识。
