Full Text:

 

¿µ³²ÀÇ´ëÇмúÁö Vol.24_No.2 Suppl. P.S49-56, Dec. 2007

Review

¿äÃß Ã´Ãß°ü ÇùÂøÁõÀÇ ÀÚ¿¬ °æ°ú

Natural Course of Lumbar Spinal Stenosis

¾È¸éȯ
¿µ³²´ëÇб³ Àǰú´ëÇÐ Á¤Çü¿Ü°úÇб³½Ç
Ã¥ÀÓÀúÀÚ£º¾È¸éȯ, ´ë±¸±¤¿ª½Ã ³²±¸ ´ë¸íµ¿ 317-1, ¿µ³²´ëÇб³ Àǰú´ëÇÐ Á¤Çü¿Ü°úÇб³½Ç
Tel: (053) 620-3643, Fax: (053) 628-4020
E-mail : mwahn@med.yu.ac.kr

December 30, 2007

Abstract

The purpose of this paper is to review the natural course of spinal stenosis in order to establish an optimal therapeutic plan. As the population becomes older, this condition is encountered more frequently. The numbers of detected cases were increased internationally with the diagnositc tools improved. Good knowledge of natural evolution and of the predictive factors influencing the course of the disease is crucial for the selection of methods of treatment. Unfortunately, in contrast with numerous reports of the results of surgical series, few studies have been reported on the natural evolution. However, results of the studies analyzed in this review suggest that a substantial proportion of patients do not automatically deteriorate and will remain unchanged or even improved by medical means. They also suggest that patients with severe baseline symptoms, block stenosis and degenerative spondylolisthesis tend to require surgical decompression.

Key Words: Lumbar, Spinal stenosis, Spondylolisthesis, Natural course

References

1. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934;211:210-5.

2. Verbiest H. A radicular syndrome from developmental narrowing of the lumbar vertebral canal. J Bone Joint Surg 1954 May;36-B:230-7.

3. Bailey P, Casamayor L. Osteoarthritis of the spine as a cause of compression of the spinal cord and its roots. J Nerve Mental Dis 1911; 38:588-609.

4. Blau JN, Logue V. The natural history of intermittent claudication of the cauda equina. A long term follow-up study. Brain 1978 Jun; 101(2):211-22.

5. Elsberg CA. Experiences in spinal surgery: Observations upon 60 laminectomies for spinal disease. Surg Gynecol Obstet 1913;16:117-32.

6. Epstein JA, Epstein BS, Lavine L. Nerve rot compression associated with narrowing of the lumbar spinal canal. J Neurol Neurosurg Psychiatry 1962 May;25:165-76.

7. Bridwell KH. Lumbar spinal stenosis. Diagnosis, management, and treatment. Clin Geriatr Med 1994 Nov;10(4):677-701.

8. Herno A, Airaksinen O, Saari T, Luukkonen M. Lumbar spinal stenosis: a matched-pair study of operated and non-operated patients. Br J Neurosurg 1996 Oct;10(5):461-5.

9. Johnsson KE, Rosen I, Uden A. The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 1992 Jun;279:82-6.

10. Lehto MU, Honkanen P. Factors influencing the outcome of operative treatment for lumbar spinal stenosis. Acta Neurochir (Wien) 1995; 137(1-2):25-8.

11. Arnoldi CC, Brodsky AE, Cauchoix J, Crock HV, Dommisse GF, Edgar MA, et al. Lumbar spinal stenosis and nerve root entrapment syndromes. Definition and classification. Clin Orthop Relat Res 1976 Mar-Apr;115:4-5.

12. Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res 1982 May;165:110-23.

13. Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res 1976 Jun;117:23-9.

14. Marchetti PG, Bartolozzi P. Classification of spondylolisthesis as a guideline for treatment. In: Bridwell KH, Dewald RL, Hammerberg KW et al, editors. Textbook of Spinal Surgery, 2nd edn. Philadelphia: Lippincott?Raven 1997; 1211-54.

15. Katz JN, Lipson SJ, Chang LC, Levine SA, Fossel AH, Liang MH. Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine 1996 Jan 1;21(1):92-8.

16. Amundsen T, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleas F. Lumbar spinal stenosis: conservative or surgical management?: A prospective 10-year study. Spine 2000 Jun 1;25(11):1424-35.

17. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 1984 Jun;66(5):699-707.

18. Saraste H. Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. J Pediatr Orthop 1987 Nov-Dec;7(6):631-8.

19. Lauerman WC, Cain JE. Isthmic Spondylolis- thesis in the Adult. J Am Acad Orthop Surg 1996 Jul;4(4):201-8.

20. Saraste H. Spondylolysis and spondylolisthesis. Acta Orthop Scand Suppl 1993;251:84-6.

21. Rosenberg NJ. Degenerative spondylolisthesis. Predisposing factors. J Bone Joint Surg Am 1975 Jun;57(4):467-74.

22. Matsunaga S, Sakou T, Morizono Y, Masuda A, Demirtas AM. Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine 1990 Nov;15(11): 1204-10.

23. Frymoyer JW. Degenerative Spondylolisthesis: Diagnosis and Treatment. J Am Acad Orthop Surg 1994 Jan;2(1):9-15.

24. Matsunaga S, Ijiri K, Hayashi K. Nonsurgically managed patients with degenerative spondylo- listhesis: a 10- to 18-year follow-up study. J Neurosurg 2000 Oct;93(2 Suppl):194-8.