Analysis of cauda equina compression in lumobar spinal stenosis

点击翻译按钮获取中文摘要

The study of epidural pressure measurements clearly demonstrated that the local extradural pressure at the stenotic level was changed by motion in patients with spinal stenosis. The pressure was low in lying and sitting, and high in standing. Especially, the pressure was increased by lumbar extension, but decreased by forward flexion. Changes of the epidural pressure correlated with the occurence of clinical symptoms of nerve roots compression. These pressure changes may explain the postural dependency of symptoms in spinal stenosisThe epidural pressure was also changed at walking in patients with neurogenic intermittent claudication. The epidural pressure change had a pattern of increase and decrease, and this pattern was repeated during walking. The epidural pressure was high at simple walking and low at walking with lumbar flexion. Intermittent compression to the nerve roots during walking might have a important role in the pathogenesis of neurogenic intermittent claudicationThe pressure was extremely increased by trunk muscle exercises e. g. back muscle strength exercise. This result imply that back muscle exercise might be dangerous for patients with lumbar spinal stenosisIn conclusion, static compression in lumbar spinal stenosis is low compared to lumbar disc herniation. Dynamic compression by lumbar motion would be important for the pathophysiology of lumbar spinal stenosis