Abstract
Lumbar spinal stenosis and lumbar disc herniation are usually regarded as two pathogenetically different conditions, but in the literature lumbar disc herniation in patients with developmental spinal stenosis has been rarely documented. In a clinical retrospective study, 42 lumbar disc herniations with developmental spinal stenosis were reported and analyzed. Discectomy was performed after laminotomy. The patients were followed-up for an average of 4.4 years (range 2–7 years). The preoperative symptoms disappeared completely in 28 patients, in 13 patients some degree of backache remained although their nerve root pain had been relieved, and in 1 patient intermittent claudication reappeared after 6 years resolution of their preoperative pain. We conclude that when developmental spinal stenosis is combined with disc herniation, discectomy through laminotomy rather than laminectomy is usually sufficient for decompression.
Similar content being viewed by others
References
Arnoldi CC, Brodsky AE, Canchoix J, Crock HV, Dommisse GF, Edgar MA, Gargano FP, Jacobson RE, Kirkaldy-Willis WH, Kurihara A, Langenskiold A, Macnab I, McIvor GWQD, Newman PH, Paine KWE, Russin LA, Sheldon J, Tile M, Urist MR, Wilson WE, Wiltsa LL (1976) Lumbar spinal stenosis and nerve root entrapment syndromes: definition and classification. Clin Orthop 115:4–5
Aryanpur J, Ducker T (1988) Multilevel lumbar laminotomies for focal spinal stenosis: case report. Neurosurgery 23:111–115
Aryanpur J, Ducker T (1990) Multilevel lumbar laminotomies: an alternative to laminectomy in the treatment of lumbar stenosis. Neurosurgery 26: 429–433
Chondhury AR, Taylor JC (1977) Occult lumbar spinal stenosis. J Neurol Neurosurg Psychiatry 40:506–510
Dai L, Xu Y, Zhang W, Zhou Z, Wang Y (1988) Effect of posterior structure resection on lumbar spine stability: a preliminary biomechanical study. Chin Med J 101:272–276
Dai L, Xu Y, Zhang W, Zhou Z, (1989) The effect of flexion-extension motion of the lumbar spine on the capacity of spinal canal: an experimental study. Spine 14:523–525
Dai L, Xu Y, Zhang W, Zhou Z (1992) Hypermobility induced by posterior element resection: an experimental study. Chin J Biomed Eng 9:49–53
Dai L, Cheng P, Tu K, Xu Y, Zhang W (1995) The effect of posterior element resection on the stress distribution in the lumbar spine. Chin Med Sci J 10: 113–115
Eisenstein S (1977) The morphometry and pathological anatomy of the lumbar spine in South African negros and Caucasoids with specific reference to spinal stenosis. J Bone Joint Surg [Br] 59:173–180
Hopp E, Tsou PM (1988) Postcompression lumbar instability. Clin Orthop 227:143–151
Johnsson K, Willner S, Johnsson K (1986) Postoperative instability after decompression for lumbar spinal stenosis. Spine 11:107–110
Kawai S, Hattori S, Oda H, Yamaguchi Y, Yashida Y (1981) Entargement of the lumbar vertebral canal in lumbar canal stenosis. Spine 6:381–387
Kornberg M, Rechtine Gr, Dupuy TE (1984) The treatment of a herniated lumbar disc in a young adult with developmental spinal stenosis. Spine 9: 541–545
Lee CK, Hansen HT, Weiss AB (1978) Developmental lumbar spinal stenosis: pathology and surgical treatment. Spine 3:246–255
Lin PM (1982) Internal decompression for multiple levels of lumbar spinal stenosis: a technical note. Neurosurgery 11:546–549
Lin M, Zang J, Zhang Y, Li L, Zhou B, Sun J (1983) Radiographic measurements of the size and shape of lumbar spinal canal (in Chinese). Chin J Orthop 3:66–68
Nakai O, Ookawa A, Yamaura I (1991) Longterm reoentgenographic and functional changes in patients who were treated with wide fenestration for central lumbar stenosis. J Bone Joint Surg [Am] 73:1184–1191
Paine KWE (1976) Results of decompression for lumbar spinal stenosis. Clin Orthop 115:96–100
Postacchini F, Cinotti G, Perugia D, Gumina S (1993) The surgical treatment of central lumbar stenosis: multiple laminotomy compared with total laminectomy. J Bone Joint Surg [Br] 75:386–392
Porter RW, Hibbert CS, Wicks M (1978) The spinal canal in symptomatic lumbar disc lesions. J Bone Joint Surg [Br] 60:485–487
Senegas J, Etchevers JP, Vital JM, Baulny D, Grenler F (1988) Le recalibrage du canal lombaire: alternative à la laminectomie dans le traitement des sténoses du canal lombaire. Rev Chir Orthop 74:15–22
Shenkin HA, Hash CJ (1979) Spondylolisthesis after multiple bilateral laminectomies for lumbar spondylosis: follow-up review. J Neurosurg 50: 45–47
Sienkiewicz PJ, Flatley TJ (1987) Postoperative spondylolisthesis. Clin Orthop 221:172–180
Turner JA, Ersek M, Herron L, Deyo R (1992) Surgery for lumbar spinal stenosis: attempted meta-analysis of the literature. Spine 17:1–8
Verbiest H (1954) A radicular syndrome from developmental narrowing of the lumbar vertebral canal. J Bone Joint Surg [Br] 36:230–237
Verbiest H (1955) Further experiences on the pathological influence of a developmental narrowness of the bony lumbar vertebral canal. J Bone Joint Surg [Br] 37:576–583
Verbiest H (1977) Results of surgical treatment of idiopathic developmental stenosis of the lumbar vertebral canal: a review of twenty-seven experiences. J Bone Joint Surg [Br] 59:181–188
Weisz GM, Lee P (1983) Spinal canal stenosis. Concept of spinal reserve capacity: radiologic measurements and clinical application. Clin Orthop 179: 134–140
Wynne-Davies R, Walsh WK, Gormley J (1981) Achondroplasia and hypochondroplasia: clinical variation and spinal stenosis. J Bone Joint Surg [Br] 63:508–515
Winston K, Rimbaugh C, Colucci V (1984) The vertebral canals in lumbar disc disease. Spine 9:414–417
Xu Y, Jia L, Dai L, Xu Y, Lu L, Hu Y (1992) New techniques in the management of acquired lumbar spinal stenosis (in Chinese). Chin J Orthop 12:37–40
Young S, Veerpen R, O'Laoire SA (1980) Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report. Neurosurgery 23:628–633
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dai, L.Y., Ni, B., Jia, L.S. et al. Lumbar disc herniation in patients with developmental spinal stenosis. Eur Spine J 5, 308–311 (1996). https://doi.org/10.1007/BF00304345
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00304345