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01.06.2006 | CME Weiterbildung · Zertifizierte Fortbildung

Lumbale Spinalkanalstenose

verfasst von: Dr. T. L. Schulte, V. Bullmann, T. Lerner, M. Schneider, B. Marquardt, U. Liljenqvist, T. A. Pietilä, L. Hackenberg

Erschienen in: Die Orthopädie | Ausgabe 6/2006

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Zusammenfassung

Der lumbalen Spinalkanalstenose kommt aufgrund der sich wandelnden Bevölkerungsstruktur und des wachsenden Anspruchs älterer Patienten an die Lebensqualität eine immer größere Bedeutung zu. Die aktuellen Behandlungsempfehlungen basieren weniger auf nachgewiesener Evidenz als auf klinischer Erfahrung, Expertenmeinungen und Einzelstudien. Das radiologische Ausmaß einer Stenose korreliert nicht mit der klinischen Situation der Patienten. Es stellt nicht das Kriterium zur Operation dar, sondern die typische Anamnese und Claudicatio spinalis. Symptomatische Patienten mit leichten bis mittelschweren Beschwerden sollten multimodal konservativ behandelt werden. Epidurale Infiltrationen und entlordosierende Maßnahmen sind sinnvoll, ggf. auch eine medikamentöse Therapie. Bei hochgradigen symptomatischen Stenosen sollte nach erfolglosem konservativem Therapieversuch über 3 Monate eine operative Therapie erfolgen. Hochgradige Paresen oder Kaudasyndrom sind absolute Operationsindikationen. Ziel ist eine optimale Dekompression bei größtmöglichem Erhalt oder Wiederherstellung der Segmentstabilität. Eine Laminektomie ist nicht erforderlich. Bei begleitender degenerativer Spondylolisthese Meyerding Grad I–II oder Hypermobilität in den Funktionsaufnahmen ist zusätzlich zur Dekompression abhängig vom Alter und Aktivitätsgrad des Patienten eine Fusion oder dynamische Stabilisierung anzustreben.
Literatur
1.
Zurück zum Zitat Adamova B, Vohanka S, Dusek L (2005) Dynamic electrophysiological examination in patients with lumbar spinal stenosis: is it useful in clinical practice? Eur Spine J 14: 269–276PubMed Adamova B, Vohanka S, Dusek L (2005) Dynamic electrophysiological examination in patients with lumbar spinal stenosis: is it useful in clinical practice? Eur Spine J 14: 269–276PubMed
2.
Zurück zum Zitat Amundsen T, Weber H, Nordal HJ et al. (2000) Lumbar spinal stenosis: conservative or surgical management? A prospective 10-year study. Spine 25: 1424–1435; discussion 1435–1436CrossRefPubMed Amundsen T, Weber H, Nordal HJ et al. (2000) Lumbar spinal stenosis: conservative or surgical management? A prospective 10-year study. Spine 25: 1424–1435; discussion 1435–1436CrossRefPubMed
3.
Zurück zum Zitat Atlas SJ, Delitto A (2006) Spinal stenosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res 443: 198–207CrossRefPubMed Atlas SJ, Delitto A (2006) Spinal stenosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res 443: 198–207CrossRefPubMed
4.
Zurück zum Zitat Atlas SJ, Deyo RA, Keller RB et al. (1996) The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine 21: 1787–1794; discussion 1794–1795CrossRefPubMed Atlas SJ, Deyo RA, Keller RB et al. (1996) The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine 21: 1787–1794; discussion 1794–1795CrossRefPubMed
5.
Zurück zum Zitat Atlas SJ, Keller RB, Robson D et al. (2000) Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine 25: 556–562CrossRefPubMed Atlas SJ, Keller RB, Robson D et al. (2000) Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine 25: 556–562CrossRefPubMed
6.
Zurück zum Zitat Atlas SJ, Keller RB, Wu YA et al. (2005) Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine 30: 936–943CrossRefPubMed Atlas SJ, Keller RB, Wu YA et al. (2005) Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine 30: 936–943CrossRefPubMed
7.
Zurück zum Zitat AWMF-Leitlinien (2005) Leitlinien der Deutschen Gesellschaft für Neurochirurgie „Lumbale Spinalkanalstenose“ AWMF-Leitlinien (2005) Leitlinien der Deutschen Gesellschaft für Neurochirurgie „Lumbale Spinalkanalstenose“
8.
Zurück zum Zitat Bal S, Celiker R, Palaoglu S, Cila A (2006) F wave studies of neurogenic intermittent claudication in lumbar spinal stenosis. Am J Phys Med Rehabil 85: 135–140CrossRefPubMed Bal S, Celiker R, Palaoglu S, Cila A (2006) F wave studies of neurogenic intermittent claudication in lumbar spinal stenosis. Am J Phys Med Rehabil 85: 135–140CrossRefPubMed
9.
Zurück zum Zitat Benz RJ, Ibrahim ZG, Afshar P, Garfin SR (2001) Predicting complications in elderly patients undergoing lumbar decompression. Clin Orthop Relat Res 384: 116–121CrossRefPubMed Benz RJ, Ibrahim ZG, Afshar P, Garfin SR (2001) Predicting complications in elderly patients undergoing lumbar decompression. Clin Orthop Relat Res 384: 116–121CrossRefPubMed
10.
Zurück zum Zitat Boden SD, Davis DO, Dina TS et al. (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72: 403–408PubMed Boden SD, Davis DO, Dina TS et al. (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72: 403–408PubMed
11.
Zurück zum Zitat Cahill P, Bell GR, Ghanayem AJ (2004) Lumbar spinal stenosis, Part I and II. Cont Spine Surg 5: 56–68 Cahill P, Bell GR, Ghanayem AJ (2004) Lumbar spinal stenosis, Part I and II. Cont Spine Surg 5: 56–68
12.
Zurück zum Zitat Chang Y, Singer DE, Wu YA et al. (2005) The effect of surgical and nonsurgical treatment on longitudinal outcomes of lumbar spinal stenosis over 10 years. J Am Geriatr Soc 53: 785–792CrossRefPubMed Chang Y, Singer DE, Wu YA et al. (2005) The effect of surgical and nonsurgical treatment on longitudinal outcomes of lumbar spinal stenosis over 10 years. J Am Geriatr Soc 53: 785–792CrossRefPubMed
13.
Zurück zum Zitat Chosa E, Sekimoto T, Kubo S, Tajima N (2005) Evaluation of circulatory compromise in the leg in lumbar spinal canal stenosis. Clin Orthop Relat Res 431: 129–133CrossRefPubMed Chosa E, Sekimoto T, Kubo S, Tajima N (2005) Evaluation of circulatory compromise in the leg in lumbar spinal canal stenosis. Clin Orthop Relat Res 431: 129–133CrossRefPubMed
14.
Zurück zum Zitat Christie SD, Song JK, Fessler RG (2005) Dynamic interspinous process technology. Spine 30: S73–78CrossRefPubMed Christie SD, Song JK, Fessler RG (2005) Dynamic interspinous process technology. Spine 30: S73–78CrossRefPubMed
15.
Zurück zum Zitat Danielson B, Willen J (2001) Axially loaded magnetic resonance image of the lumbar spine in asymptomatic individuals. Spine 26: 2601–2606CrossRefPubMed Danielson B, Willen J (2001) Axially loaded magnetic resonance image of the lumbar spine in asymptomatic individuals. Spine 26: 2601–2606CrossRefPubMed
16.
Zurück zum Zitat Delank KS, Eysel P, Zollner J et al. (2002) Undercutting decompression versus laminectomy. Clinical and radiological results of a prospective controlled trial. Orthopade 31: 1048–1056; discussion 1057CrossRefPubMed Delank KS, Eysel P, Zollner J et al. (2002) Undercutting decompression versus laminectomy. Clinical and radiological results of a prospective controlled trial. Orthopade 31: 1048–1056; discussion 1057CrossRefPubMed
17.
Zurück zum Zitat Deyo RA (1996) Drug therapy for back pain. Which drugs help which patients? Spine 21: 2840–2849; discussion 2849–2850CrossRefPubMed Deyo RA (1996) Drug therapy for back pain. Which drugs help which patients? Spine 21: 2840–2849; discussion 2849–2850CrossRefPubMed
18.
Zurück zum Zitat Deyo RA, Cherkin DC, Loeser JD et al. (1992) Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure. J Bone Joint Surg Am 74: 536–543PubMed Deyo RA, Cherkin DC, Loeser JD et al. (1992) Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure. J Bone Joint Surg Am 74: 536–543PubMed
19.
Zurück zum Zitat Deyo RA, Ciol MA, Cherkin DC et al. (1993) Lumbar spinal fusion. A cohort study of complications, reoperations, and resource use in the Medicare population. Spine 18: 1463–1470PubMed Deyo RA, Ciol MA, Cherkin DC et al. (1993) Lumbar spinal fusion. A cohort study of complications, reoperations, and resource use in the Medicare population. Spine 18: 1463–1470PubMed
20.
Zurück zum Zitat DiMaio S, Marmor E, Albrecht S, Mohr G (2005) Ligamentum flavum cysts causing incapacitating lumbar spinal stenosis. Can J Neurol Sci 32: 237–242PubMed DiMaio S, Marmor E, Albrecht S, Mohr G (2005) Ligamentum flavum cysts causing incapacitating lumbar spinal stenosis. Can J Neurol Sci 32: 237–242PubMed
21.
22.
Zurück zum Zitat Feldmann PH, Wittenberg RH (2003) Surgical treatment of spinal stenosis. Orthopade 32: 877–888CrossRefPubMed Feldmann PH, Wittenberg RH (2003) Surgical treatment of spinal stenosis. Orthopade 32: 877–888CrossRefPubMed
23.
Zurück zum Zitat Fogel GR, Cunningham PY 3rd, Esses SI (2005) Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J 5: 202–211CrossRefPubMed Fogel GR, Cunningham PY 3rd, Esses SI (2005) Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J 5: 202–211CrossRefPubMed
24.
Zurück zum Zitat Fokter SK, Yerby SA (2005) Patient-based outcomes for the operative treatment of degenerative lumbar spinal stenosis. Eur Spine J 21: 1–9CrossRef Fokter SK, Yerby SA (2005) Patient-based outcomes for the operative treatment of degenerative lumbar spinal stenosis. Eur Spine J 21: 1–9CrossRef
25.
Zurück zum Zitat Fukusaki M, Kobayashi I, Hara T, Sumikawa K (1998) Symptoms of spinal stenosis do not improve after epidural steroid injection. Clin J Pain 14: 148–151CrossRefPubMed Fukusaki M, Kobayashi I, Hara T, Sumikawa K (1998) Symptoms of spinal stenosis do not improve after epidural steroid injection. Clin J Pain 14: 148–151CrossRefPubMed
26.
Zurück zum Zitat Galiano K, Obwegeser AA, Gabl MV et al. (2005) Long-term outcome of laminectomy for spinal stenosis in octogenarians. Spine 30: 332–335CrossRefPubMed Galiano K, Obwegeser AA, Gabl MV et al. (2005) Long-term outcome of laminectomy for spinal stenosis in octogenarians. Spine 30: 332–335CrossRefPubMed
27.
Zurück zum Zitat Gelalis ID, Stafilas KS, Korompilias AV et al. (2006) Decompressive surgery for degenerative lumbar spinal stenosis: long-term results. Int Orthop 30: 59–63CrossRefPubMed Gelalis ID, Stafilas KS, Korompilias AV et al. (2006) Decompressive surgery for degenerative lumbar spinal stenosis: long-term results. Int Orthop 30: 59–63CrossRefPubMed
28.
Zurück zum Zitat Gibson JN, Waddell G (2005) Surgery for degenerative lumbar spondylosis: updated Cochrane Review. Spine 30: 2312–2320CrossRefPubMed Gibson JN, Waddell G (2005) Surgery for degenerative lumbar spondylosis: updated Cochrane Review. Spine 30: 2312–2320CrossRefPubMed
29.
Zurück zum Zitat Grob D, Benini A, Junge A, Mannion AF (2005) Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine 30: 324–331CrossRefPubMed Grob D, Benini A, Junge A, Mannion AF (2005) Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine 30: 324–331CrossRefPubMed
30.
Zurück zum Zitat Haba K, Ikeda M, Soma M, Yamashima T (2005) Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach. J Clin Neurosci 12: 169–171PubMed Haba K, Ikeda M, Soma M, Yamashima T (2005) Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach. J Clin Neurosci 12: 169–171PubMed
31.
Zurück zum Zitat Haig AJ, Tong HC, Yamakawa KS et al. (2005) The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 30: 2667–2676CrossRefPubMed Haig AJ, Tong HC, Yamakawa KS et al. (2005) The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 30: 2667–2676CrossRefPubMed
32.
Zurück zum Zitat Herno A, Airaksinen O, Saari T, Luukkonen M (1996) Lumbar spinal stenosis: a matched-pair study of operated and non-operated patients. Br J Neurosurg 10: 461–465CrossRefPubMed Herno A, Airaksinen O, Saari T, Luukkonen M (1996) Lumbar spinal stenosis: a matched-pair study of operated and non-operated patients. Br J Neurosurg 10: 461–465CrossRefPubMed
33.
Zurück zum Zitat Herno A, Saari T, Suomalainen O, Airaksinen O (1999) The degree of decompressive relief and its relation to clinical outcome in patients undergoing surgery for lumbar spinal stenosis. Spine 24:1010–1014CrossRefPubMed Herno A, Saari T, Suomalainen O, Airaksinen O (1999) The degree of decompressive relief and its relation to clinical outcome in patients undergoing surgery for lumbar spinal stenosis. Spine 24:1010–1014CrossRefPubMed
34.
Zurück zum Zitat Ikuta K, Arima J, Tanaka T et al. (2005) Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note. J Neurosurg Spine 2: 624–633PubMed Ikuta K, Arima J, Tanaka T et al. (2005) Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note. J Neurosurg Spine 2: 624–633PubMed
35.
Zurück zum Zitat Jansson KA, Nemeth G, Granath F, Blomqvist P (2005) Spinal stenosis re-operation rate in Sweden is 11% at 10 years – a national analysis of 9,664 operations. Eur Spine J 14: 659–663CrossRefPubMed Jansson KA, Nemeth G, Granath F, Blomqvist P (2005) Spinal stenosis re-operation rate in Sweden is 11% at 10 years – a national analysis of 9,664 operations. Eur Spine J 14: 659–663CrossRefPubMed
36.
Zurück zum Zitat Johnsson KE (1995) Lumbar spinal stenosis. A retrospective study of 163 cases in southern Sweden. Acta Orthop Scand 66: 403–405PubMed Johnsson KE (1995) Lumbar spinal stenosis. A retrospective study of 163 cases in southern Sweden. Acta Orthop Scand 66: 403–405PubMed
37.
Zurück zum Zitat Johnsson KE, Rosen I, Uden A (1992) The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 279: 82–86PubMed Johnsson KE, Rosen I, Uden A (1992) The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 279: 82–86PubMed
38.
Zurück zum Zitat Jonsson B, Annertz M, Sjoberg C, Stromqvist B (1997) A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: Five-year follow-up by an independent observer. Spine 22: 2938–2944CrossRefPubMed Jonsson B, Annertz M, Sjoberg C, Stromqvist B (1997) A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: Five-year follow-up by an independent observer. Spine 22: 2938–2944CrossRefPubMed
39.
Zurück zum Zitat Katz JN, Stucki G, Lipson SJ et al. (1999) Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine 24: 2229–2233CrossRefPubMed Katz JN, Stucki G, Lipson SJ et al. (1999) Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine 24: 2229–2233CrossRefPubMed
40.
Zurück zum Zitat Kawaguchi Y, Kanamori M, Ishihara H et al. (2005) Clinical and radiographic results of expansive lumbar laminoplasty in patients with spinal stenosis. J Bone Joint Surg Am 87 [Suppl 1]: 292–299 Kawaguchi Y, Kanamori M, Ishihara H et al. (2005) Clinical and radiographic results of expansive lumbar laminoplasty in patients with spinal stenosis. J Bone Joint Surg Am 87 [Suppl 1]: 292–299
41.
Zurück zum Zitat Kawaguchi Y, Oya T, Abe Y et al. (2005) Spinal stenosis due to ossified lumbar lesions. J Neurosurg Spine 3: 262–270PubMed Kawaguchi Y, Oya T, Abe Y et al. (2005) Spinal stenosis due to ossified lumbar lesions. J Neurosurg Spine 3: 262–270PubMed
42.
Zurück zum Zitat Kleeman TJ, Hiscoe AC, Berg EE (2000) Patient outcomes after minimally destabilizing lumbar stenosis decompression: the „Port-Hole“ technique. Spine 25: 865–870CrossRefPubMed Kleeman TJ, Hiscoe AC, Berg EE (2000) Patient outcomes after minimally destabilizing lumbar stenosis decompression: the „Port-Hole“ technique. Spine 25: 865–870CrossRefPubMed
43.
Zurück zum Zitat Kobayashi S, Baba H, Uchida K et al. (2005) Blood circulation of cauda equina and nerve root. Clin Calcium 15: 63–72PubMed Kobayashi S, Baba H, Uchida K et al. (2005) Blood circulation of cauda equina and nerve root. Clin Calcium 15: 63–72PubMed
44.
Zurück zum Zitat Kobayashi S, Kokubo Y, Uchida K et al. (2005) Effect of lumbar nerve root compression on primary sensory neurons and their central branches: changes in the nociceptive neuropeptides substance P and somatostatin. Spine 30: 276–282CrossRefPubMed Kobayashi S, Kokubo Y, Uchida K et al. (2005) Effect of lumbar nerve root compression on primary sensory neurons and their central branches: changes in the nociceptive neuropeptides substance P and somatostatin. Spine 30: 276–282CrossRefPubMed
45.
Zurück zum Zitat Kobayashi S, Uchida K, Takeno K et al. (2006) Imaging of cauda equina edema in lumbar canal stenosis by using gadolinium-enhanced MR imaging: experimental constriction injury. Am J Neuroradiol 27: 346–353PubMed Kobayashi S, Uchida K, Takeno K et al. (2006) Imaging of cauda equina edema in lumbar canal stenosis by using gadolinium-enhanced MR imaging: experimental constriction injury. Am J Neuroradiol 27: 346–353PubMed
46.
Zurück zum Zitat Kornblum MB, Fischgrund JS, Herkowitz HN et al. (2004) Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine 29: 726–733; discussion 733–734CrossRefPubMed Kornblum MB, Fischgrund JS, Herkowitz HN et al. (2004) Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine 29: 726–733; discussion 733–734CrossRefPubMed
47.
Zurück zum Zitat Lee CK, Rauschning W, Glenn W (1988) Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression. Spine 13: 313–320PubMed Lee CK, Rauschning W, Glenn W (1988) Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression. Spine 13: 313–320PubMed
48.
Zurück zum Zitat Lurie JD, Birkmeyer NJ, Weinstein JN (2003) Rates of advanced spinal imaging and spine surgery. Spine 28: 616–620CrossRefPubMed Lurie JD, Birkmeyer NJ, Weinstein JN (2003) Rates of advanced spinal imaging and spine surgery. Spine 28: 616–620CrossRefPubMed
49.
Zurück zum Zitat Mackay DC, Wheelwright EF (1998) Unilateral fenestration in the treatment of lumbar spinal stenosis. Br J Neurosurg 12: 556–558CrossRefPubMed Mackay DC, Wheelwright EF (1998) Unilateral fenestration in the treatment of lumbar spinal stenosis. Br J Neurosurg 12: 556–558CrossRefPubMed
50.
Zurück zum Zitat Mardjetko SM, Connolly PJ, Shott S (1994) Degenerative lumbar spondylolisthesis. A meta-analysis of literature 1970–1993. Spine 19: 2256S–2265SPubMed Mardjetko SM, Connolly PJ, Shott S (1994) Degenerative lumbar spondylolisthesis. A meta-analysis of literature 1970–1993. Spine 19: 2256S–2265SPubMed
51.
Zurück zum Zitat Matsudaira K, Yamazaki T, Seichi A et al. (2005) Spinal stenosis in grade I degenerative lumbar spondylolisthesis: a comparative study of outcomes following laminoplasty and laminectomy with instrumented spinal fusion. J Orthop Sci 10: 270–276CrossRefPubMed Matsudaira K, Yamazaki T, Seichi A et al. (2005) Spinal stenosis in grade I degenerative lumbar spondylolisthesis: a comparative study of outcomes following laminoplasty and laminectomy with instrumented spinal fusion. J Orthop Sci 10: 270–276CrossRefPubMed
52.
Zurück zum Zitat Matsumoto T, Yoshida M, Yamada H et al. (2001) Lumbar canal stenosis caused by hypertrophy of the posterior longitudinal ligament: case report. Spine 26: E576–579CrossRefPubMed Matsumoto T, Yoshida M, Yamada H et al. (2001) Lumbar canal stenosis caused by hypertrophy of the posterior longitudinal ligament: case report. Spine 26: E576–579CrossRefPubMed
53.
Zurück zum Zitat Mayer HM, List J, Korge A, Wiechert K (2003) Microsurgery of acquired degenerative lumbar spinal stenosis. Bilateral over-the-top decompression through unilateral approach. Orthopade 32: 889–895CrossRefPubMed Mayer HM, List J, Korge A, Wiechert K (2003) Microsurgery of acquired degenerative lumbar spinal stenosis. Bilateral over-the-top decompression through unilateral approach. Orthopade 32: 889–895CrossRefPubMed
54.
Zurück zum Zitat Moon ES, Kim HS, Park JO et al. (2005) Comparison of the predictive value of myelography, computed tomography and MRI on the treadmill test in lumbar spinal stenosis. Yonsei Med J 46: 806–811PubMed Moon ES, Kim HS, Park JO et al. (2005) Comparison of the predictive value of myelography, computed tomography and MRI on the treadmill test in lumbar spinal stenosis. Yonsei Med J 46: 806–811PubMed
55.
Zurück zum Zitat Murphy DR, Hurwitz EL, Gregory AA, Clary R (2006) A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study. BMC Musculoskelet Disord 7: 16CrossRefPubMed Murphy DR, Hurwitz EL, Gregory AA, Clary R (2006) A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study. BMC Musculoskelet Disord 7: 16CrossRefPubMed
56.
Zurück zum Zitat Nelemans PJ, deBie RA, deVet HC, Sturmans F (2001) Injection therapy for subacute and chronic benign low back pain. Spine 26: 501–515CrossRefPubMed Nelemans PJ, deBie RA, deVet HC, Sturmans F (2001) Injection therapy for subacute and chronic benign low back pain. Spine 26: 501–515CrossRefPubMed
57.
Zurück zum Zitat Ng L, Chaudhary N, Sell P (2005) The efficacy of corticosteroids in periradicular infiltration for chronic radicular pain: a randomized, double-blind, controlled trial. Spine 30: 857–862CrossRefPubMed Ng L, Chaudhary N, Sell P (2005) The efficacy of corticosteroids in periradicular infiltration for chronic radicular pain: a randomized, double-blind, controlled trial. Spine 30: 857–862CrossRefPubMed
58.
Zurück zum Zitat Ng LC, Tafazal S, Sell P (2006) The effect of duration of symptoms on standard outcome measures in the surgical treatment of spinal stenosis. Eur Spine J, Epub ahead of print Ng LC, Tafazal S, Sell P (2006) The effect of duration of symptoms on standard outcome measures in the surgical treatment of spinal stenosis. Eur Spine J, Epub ahead of print
59.
Zurück zum Zitat Pahl MA, Brislin B, Boden S et al. (2006) The impact of four common lumbar spine diagnoses upon overall health status. Spine J 6: 125–130CrossRefPubMed Pahl MA, Brislin B, Boden S et al. (2006) The impact of four common lumbar spine diagnoses upon overall health status. Spine J 6: 125–130CrossRefPubMed
60.
Zurück zum Zitat Park JB, Lee JK, Park SJ, Riew KD (2005) Hypertrophy of ligamentum flavum in lumbar spinal stenosis associated with increased proteinase inhibitor concentration. J Bone Joint Surg Am 87: 2750–2757CrossRefPubMed Park JB, Lee JK, Park SJ, Riew KD (2005) Hypertrophy of ligamentum flavum in lumbar spinal stenosis associated with increased proteinase inhibitor concentration. J Bone Joint Surg Am 87: 2750–2757CrossRefPubMed
61.
Zurück zum Zitat Penning L, Wilmink JT (1987) Posture-dependent bilateral compression of L4 or L5 nerve roots in facet hypertrophy. A dynamic CT-myelographic study. Spine 12: 488–500PubMed Penning L, Wilmink JT (1987) Posture-dependent bilateral compression of L4 or L5 nerve roots in facet hypertrophy. A dynamic CT-myelographic study. Spine 12: 488–500PubMed
62.
Zurück zum Zitat Podichetty VK, Segal AM, Lieber M, Mazanec DJ (2004) Effectiveness of salmon calcitonin nasal spray in the treatment of lumbar canal stenosis: a double-blind, randomized, placebo-controlled, parallel group trial. Spine 29: 2343–2349CrossRefPubMed Podichetty VK, Segal AM, Lieber M, Mazanec DJ (2004) Effectiveness of salmon calcitonin nasal spray in the treatment of lumbar canal stenosis: a double-blind, randomized, placebo-controlled, parallel group trial. Spine 29: 2343–2349CrossRefPubMed
63.
64.
65.
Zurück zum Zitat Postacchini F, Cinotti G (1992) Bone regrowth after surgical decompression for lumbar spinal stenosis. J Bone Joint Surg Br 74: 862–869PubMed Postacchini F, Cinotti G (1992) Bone regrowth after surgical decompression for lumbar spinal stenosis. J Bone Joint Surg Br 74: 862–869PubMed
66.
Zurück zum Zitat 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: 386–392PubMed 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: 386–392PubMed
67.
Zurück zum Zitat Resnick DK, Choudhri TF, Dailey AT et al. (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: fusion in patients with stenosis and spondylolisthesis. J Neurosurg Spine 2: 679–685PubMed Resnick DK, Choudhri TF, Dailey AT et al. (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: fusion in patients with stenosis and spondylolisthesis. J Neurosurg Spine 2: 679–685PubMed
68.
Zurück zum Zitat Resnick DK, Choudhri TF, Dailey AT et al. (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: fusion following decompression in patients with stenosis without spondylolisthesis. J Neurosurg Spine 2: 686–691PubMed Resnick DK, Choudhri TF, Dailey AT et al. (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: fusion following decompression in patients with stenosis without spondylolisthesis. J Neurosurg Spine 2: 686–691PubMed
69.
Zurück zum Zitat Richards JC, Majumdar S, Lindsey DP et al. (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine 30: 744–749CrossRefPubMed Richards JC, Majumdar S, Lindsey DP et al. (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine 30: 744–749CrossRefPubMed
70.
Zurück zum Zitat Sairyo K, Biyani A, Goel V et al. (2005) Pathomechanism of ligamentum flavum hypertrophy: a multidisciplinary investigation based on clinical, biomechanical, histologic, and biologic assessments. Spine 30: 2649–2656CrossRefPubMed Sairyo K, Biyani A, Goel V et al. (2005) Pathomechanism of ligamentum flavum hypertrophy: a multidisciplinary investigation based on clinical, biomechanical, histologic, and biologic assessments. Spine 30: 2649–2656CrossRefPubMed
71.
Zurück zum Zitat Schnake KJ, Schaeren S, Jeanneret B (2006) Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis. Spine 31: 442–449CrossRefPubMed Schnake KJ, Schaeren S, Jeanneret B (2006) Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis. Spine 31: 442–449CrossRefPubMed
72.
Zurück zum Zitat Siddiqui M, Nicol M, Karadimas E et al. (2005) The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device. Spine 30: 2677–2682CrossRefPubMed Siddiqui M, Nicol M, Karadimas E et al. (2005) The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device. Spine 30: 2677–2682CrossRefPubMed
73.
Zurück zum Zitat Simotas AC (2001) Nonoperative treatment for lumbar spinal stenosis. Clin Orthop Relat Res 25(2): 153–161CrossRef Simotas AC (2001) Nonoperative treatment for lumbar spinal stenosis. Clin Orthop Relat Res 25(2): 153–161CrossRef
74.
Zurück zum Zitat Singh K, Samartzis D, Vaccaro AR et al. (2005) Congenital lumbar spinal stenosis: a prospective, control-matched, cohort radiographic analysis. Spine J 5: 615–622CrossRefPubMed Singh K, Samartzis D, Vaccaro AR et al. (2005) Congenital lumbar spinal stenosis: a prospective, control-matched, cohort radiographic analysis. Spine J 5: 615–622CrossRefPubMed
75.
Zurück zum Zitat Sinikallio S, Aalto T, Airaksinen O et al. (2006) Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil 28: 415–422CrossRefPubMed Sinikallio S, Aalto T, Airaksinen O et al. (2006) Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil 28: 415–422CrossRefPubMed
76.
Zurück zum Zitat Sinikallio S, Aalto T, Airaksinen O et al. (2006) Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment. Eur Spine J, Epub ahead of print Sinikallio S, Aalto T, Airaksinen O et al. (2006) Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment. Eur Spine J, Epub ahead of print
77.
Zurück zum Zitat Spetzger U, Bertalanffy H, Reinges MH, Gilsbach JM (1997) Unilateral laminotomy for bilateral decompression of lumbar spinal stenosis. Part II: Clinical experiences. Acta Neurochir (Wien) 139: 397–403CrossRef Spetzger U, Bertalanffy H, Reinges MH, Gilsbach JM (1997) Unilateral laminotomy for bilateral decompression of lumbar spinal stenosis. Part II: Clinical experiences. Acta Neurochir (Wien) 139: 397–403CrossRef
78.
Zurück zum Zitat Takahashi K, Kagechika K, Takino T et al. (1995) Changes in epidural pressure during walking in patients with lumbar spinal stenosis. Spine 20: 2746–2749PubMed Takahashi K, Kagechika K, Takino T et al. (1995) Changes in epidural pressure during walking in patients with lumbar spinal stenosis. Spine 20: 2746–2749PubMed
79.
Zurück zum Zitat Takahashi K, Miyazaki T, Takino T et al. (1995) Epidural pressure measurements. Relationship between epidural pressure and posture in patients with lumbar spinal stenosis. Spine 20: 650–653PubMed Takahashi K, Miyazaki T, Takino T et al. (1995) Epidural pressure measurements. Relationship between epidural pressure and posture in patients with lumbar spinal stenosis. Spine 20: 650–653PubMed
80.
Zurück zum Zitat Tender GC, Baratta RV, Voorhies RM (2005) Unilateral removal of pars interarticularis. J Neurosurg Spine 2: 279–288PubMed Tender GC, Baratta RV, Voorhies RM (2005) Unilateral removal of pars interarticularis. J Neurosurg Spine 2: 279–288PubMed
81.
Zurück zum Zitat Tender GC, Kutz S, Baratta R, Voorhies RM (2005) Unilateral progressive alterations in the lumbar spine: a biomechanical study. J Neurosurg Spine 2: 298–302PubMed Tender GC, Kutz S, Baratta R, Voorhies RM (2005) Unilateral progressive alterations in the lumbar spine: a biomechanical study. J Neurosurg Spine 2: 298–302PubMed
82.
Zurück zum Zitat Thome C, Zevgaridis D, Leheta O et al. (2005) Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg Spine 3: 129–141PubMed Thome C, Zevgaridis D, Leheta O et al. (2005) Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg Spine 3: 129–141PubMed
83.
Zurück zum Zitat Toyone T, Tanaka T, Kato D et al. (2005) Patients‘ expectations and satisfaction in lumbar spine surgery. Spine 30: 2689–2694CrossRefPubMed Toyone T, Tanaka T, Kato D et al. (2005) Patients‘ expectations and satisfaction in lumbar spine surgery. Spine 30: 2689–2694CrossRefPubMed
84.
Zurück zum Zitat Tubbs RS, Oakes WJ (2005) An unusual presentation of achondroplasia. Case report. J Neurosurg 103: 170–171 Tubbs RS, Oakes WJ (2005) An unusual presentation of achondroplasia. Case report. J Neurosurg 103: 170–171
85.
Zurück zum Zitat van Tulder M, Becker A, Bekkering T et al. (2006) Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 15: s169–s191CrossRefPubMed van Tulder M, Becker A, Bekkering T et al. (2006) Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 15: s169–s191CrossRefPubMed
86.
Zurück zum Zitat van Tulder MW, Koes B, Malmivaara A (2006) Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J 15 [Suppl 1]: S64–81 van Tulder MW, Koes B, Malmivaara A (2006) Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J 15 [Suppl 1]: S64–81
87.
Zurück zum Zitat van Tulder MW, Koes B, Seitsalo S, Malmivaara A (2006) Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review. Eur Spine J 15 [Suppl 1]: S82–92 van Tulder MW, Koes B, Seitsalo S, Malmivaara A (2006) Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review. Eur Spine J 15 [Suppl 1]: S82–92
88.
Zurück zum Zitat Vo AN, Kamen LB, Shih VC et al. (2005) Rehabilitation of orthopedic and rheumatologic disorders. 5. Lumbar spinal stenosis. Arch Phys Med Rehabil 86: S69–76CrossRefPubMed Vo AN, Kamen LB, Shih VC et al. (2005) Rehabilitation of orthopedic and rheumatologic disorders. 5. Lumbar spinal stenosis. Arch Phys Med Rehabil 86: S69–76CrossRefPubMed
89.
Zurück zum Zitat Weiner BK, Walker M, Brower RS, McCulloch JA (1999) Microdecompression for lumbar spinal canal stenosis. Spine 24: 2268–2272CrossRefPubMed Weiner BK, Walker M, Brower RS, McCulloch JA (1999) Microdecompression for lumbar spinal canal stenosis. Spine 24: 2268–2272CrossRefPubMed
90.
Zurück zum Zitat Wunschmann BW, Sigl T, Ewert T et al. (2003) Physical therapy to treat spinal stenosis. Orthopade 32: 865–868CrossRefPubMed Wunschmann BW, Sigl T, Ewert T et al. (2003) Physical therapy to treat spinal stenosis. Orthopade 32: 865–868CrossRefPubMed
91.
Zurück zum Zitat Yayama T, Baba H, Furusawa N et al. (2005) Pathogenesis of calcium crystal deposition in the ligamentum flavum correlates with lumbar spinal canal stenosis. Clin Exp Rheumatol 23: 637–643PubMed Yayama T, Baba H, Furusawa N et al. (2005) Pathogenesis of calcium crystal deposition in the ligamentum flavum correlates with lumbar spinal canal stenosis. Clin Exp Rheumatol 23: 637–643PubMed
92.
Zurück zum Zitat Zucherman JF, Hsu KY, Hartjen CA et al. (2005) A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine 30: 1351–1358CrossRefPubMed Zucherman JF, Hsu KY, Hartjen CA et al. (2005) A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine 30: 1351–1358CrossRefPubMed
Metadaten
Titel
Lumbale Spinalkanalstenose
verfasst von
Dr. T. L. Schulte
V. Bullmann
T. Lerner
M. Schneider
B. Marquardt
U. Liljenqvist
T. A. Pietilä
L. Hackenberg
Publikationsdatum
01.06.2006
Verlag
Springer-Verlag
Erschienen in
Die Orthopädie / Ausgabe 6/2006
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-006-0971-5

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