Author/Editor		Kupnik, Dejan; Brodnik, Tomaž; Praper, Lidija
Title		Lumbalna spinalna stenoza
Type		članek
Source		Med Mes
Vol. and No.		Letnik 4, št. 1
Publication year		2008
Volume		str. 23-9
Language		slo
Abstract		Lumbar spine stenosis is characterized by narrowing of the spinal canal, lateral recesus or intervertebral foramen in the lumbar part of the spine with possible compression of the spine or nerve roots, and presents as a pseudoclaudication or a radiculopathy. Most patients are aged over 50 years. Lumbar spine stenosis can be congenital or aquired. The first appears earlier in life and has less spinal degenerative changes, later appears in life and is characterized with more prominent spinal degenerative features. Symptoms comprise of neurogenic claudication or pseudoclaudication in central stenosis, and radicular pain and other symptoms in stenosis of lateral recessus. Patients usually complain of insidious onset of low back pain with progression to buttocks and legs over the course of weeks or months. The symptoms tipically worsen in erect standing position, while bending forward, walking uphill, cycling or squatting brings relief. It is important to distinguish between claudication due to peripheral artery disease and neurogenic claudication. Therapy consists of conservative measures or surgical decompression of neural tissue. The later is reserved for patients who fail to respond to conservative treatment and those with worse initial symptoms. The goal of treatment is to relieve the symptoms and to resume daily working and other activities as soon as possible.
Summary		Lumbalna spinalna stenoza je zožitev spinalnega kanala, lateralnega recesusa ali medvretenčnega foramna v ledvenem predelu, kar lahko vodi v utesnitev hrbtenjače ali živčnih korenin s posledično radikulopatijo ali psevdoklavdikacijo. Ponavadi prizadene bolnike v starosti 50 do 60 let in je lahko primarna ali kongenitalna, kjer je degenerativnih sprememb na hrbtenici manj, in sekundarna ali pridobljena, kjer so degenerativne spremembe na hrbtenici bolj izražene. Simptomi so lahko v smislu nevrogene klavdikacije ali psevdoklavdikacije pri centralni stenozi ali radikularnega tipa pri stenozi lateralnega recesusa. Največkrat obsegajo bolečino v križu in nogah, parestezije v nogah in motnje občutkov ter zmanjšanje mišične moči nog, njihova pojavnost pa je značilno vezana na zravnan položaj. Sklanjanje, hoja navkreber, vožnja kolesa ali čepenje simptome omilijo. V primeru klavdikacijskih bolečin je le-te potrebno ločiti od tistih, ki nastanejo ob periferni arterijski bolezni. Zdravljenje je konzervativno ali operativno. Slednje je namenjeno bolnikom s težkimi simptomi in tistim, ki jim konzervativno zdravljenje ne pomaga, glavni cilj zdravljenja pa je poleg omilitve simptomov tudi čimprejšnja povrnitev bolnika v vsakdanje delovne in druge aktivnosti.
Descriptors		SPINAL STENOSIS