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Stenosis of the lumbar vertebral canal and sciatica

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Summary

Stenosis of the vertebral canal is a form of compressive stenosis in contrast to transport stenosis of vessels or other channels. The concept, definition and pathomorphological properties are discussed. As it is a form of compressive stenosis, the diagnosis is based on measurements of diameters rather than of cross-sectional surfaces. The biomechanical action of compressive stenosis is compression of the fixed living content at two opposite sites or at all sites.

The special properties of sciatica in stenosis are described and presented in tabular form. Some properties of neurogenic intermittent claudication (I. Cl.) in the presence of stenosis are discussed. There is a predominance of sciatica at rest and of motor weakness during walking. The mechanism of neurogenic I. Cl. is obscure.

Stenosis of the lumbar vertebral canal is one of the conditional determinants of I. Cl. The data presented in this paper demonstrate, however, that stenosis is not an absolute determinant of I. Cl. and that its production depends on the combination with other determinants. The theory is advanced that other determinants may be related to changes in the caudal nerve roots due to either constitutional properties or to subclinical changes induced by ageing and chronic wear and tear, and compression and traction in the area of stenosis during various bodily activities. Suppression of sciatica during I. Cl. is a phenomenon which is particularly difficult to explain.

Zusammenfassung

Die Stenose des Spinalkanals ist eine Form der Druck-Stenose im Gegensatz zur Transport-Stenose von Gefäßen oder anderen Kanalsystemen. Ihre Konzeption, Definition und pathomorphologischen Eigenschaften werden beschrieben.

Die Diagnose dieser Form der Druckstenose basiert mehr auf Messungen von Durchmessern als von Querschnitt-Oberflächen. Die biomechanische Wirkung der Druckstenose beruht auf einer Kompression des unbeweglichen lebenden Inhaltes von zwei gegenüberliegenden oder von allen Seiten.

Die spezielle Ischialgie bei lumbaler Stenose wird beschrieben und tabellarisch dargestellt. Einige Eigenschaften neurogener Claudicatio intermittens (I. Cl.) bei Vorliegen der Stenose werden diskutiert: ein Vorwiegen der Ruhe-Ischialgie und der motorischen Schwäche beim Gehen. Der Mechanismus der neurogenen I. Cl. ist dunkel. Es wird die Theorie aufgestellt, daß ihre Ursachen sowohl in der Tatsache der Stenose wie in dem Zustand der caudalen Nervenwurzeln liegen. Das vorübergehende Verschwinden der Ischialgie im Laufe der I. Cl. ist besonders schwer zu erklären.

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References

  1. Armstrong, J. R.: Lumbar disc lesions. Livingstone, Edinburgh, London 1952.

    Google Scholar 

  2. Arnoldi, C. C., and twenty co-authors: Lumbar spinal stenosis and nerve root entrapment syndromes. Definition and classification. Clin. Orthop. Relat. Res. 115 (1976) 4–5.

    PubMed  Google Scholar 

  3. Eisenstein. E.: The morphometry and pathological anatomy of the lumbar spine in South African negroes and Caucasoids with specific reference to spinal stenosis. J. Bone Jt Surg. 59 B (1977) 173–180.

    Google Scholar 

  4. Elsberg, C. A., C. G. Dyke: The diagnosis and localization of tumors of the spinal cord by means of measurements made on the X-ray films of the vertebrae and the correlation of the clinical and X-ray findings. Bull. Neurol. Inst. N.Y. 3 (1934) 359–394.

    Google Scholar 

  5. Epstein, J. A., B. S. Epstein, L. Levine: Nerve root compression associated with narrowing of the lumbar spinal canal. J. Neurol. Neurosurg. Psychiat. 25 (1962) 165–176.

    PubMed  Google Scholar 

  6. Epstein, J. A., B. S. Epstein, L. Levin: The effect of anatomic variations in the lumbar vertebrae and spinal canal on cauda equina and nerve root syndromes. Amer. J. Roentgenol. 91 (1964) 1055–1063.

    PubMed  Google Scholar 

  7. Fineschi, G. F.: Patologiae Clinica dell' Ernia Posteriore del Disco Intervertebrale. Ed. Sc. Istituto Orthop., Toscano, Firenze 1955.

    Google Scholar 

  8. Forcier, P., W. J. Horsley: Calcification of the posterior longitudinal ligament at the thoracolumbar junction. J. Neurosurg. 32 (1970) 684–685.

    PubMed  Google Scholar 

  9. Huizinga, J., J. A. van der Heiden, P. J. J. G. Vinken: The human vertebral canal: a biometric study. Proc. roy. Ned. Acad. Sc. C 55 (1952) 22–33.

    Google Scholar 

  10. Jones, R. A. C., J. L. G. Thomson: The narrow lumbar canal. J. Bone Jt Surg. 50 B (1968) 595–605.

    Google Scholar 

  11. Porter, R. W., M. Wicks, D. Ottewell: Measurement of the spinal canal by diagnostic ultrasound. J. Bone Jt Surg. 60 B (1978) 481–484.

    Google Scholar 

  12. Sand, P. G.: The human lumbo-sacral vertebral column. An osteometric study. Universitet forlaget, Oslo 1970.

    Google Scholar 

  13. Sarpyener, M. A.: Congenital stricture of the spinal canal. J. Bone Jt Surg. 27 (1945) 70–79.

    Google Scholar 

  14. Sarpyener, M. A.: Spina bifida aperta and congenital stricture of the spinal canal. J. Bone Jt Surg. 29 (1947) 817–821.

    Google Scholar 

  15. Sumita, M.: Beiträge zur Lehre von der Chondrodystrophia foetalis (Kaufmann) und osteogenesis imperfecta (Vrolik) mit besonderer Berücksichtigung der anatomischen und klinischen Differential Diagnose. Dtsch. Z. Chir. 107 (1910) 1–110.

    Google Scholar 

  16. Verbiest, H.: Sur certaines formes rares de compression de la queu de cheval. In: Hommage à Clovis Vincent. Maloine, Paris 1949.

    Google Scholar 

  17. Verbiest, H.: Primaire stenose van het lumbale wervelkanaal bij volwassenen. Ned. T. Geneesk. 94 (1950) 2415–2433.

    PubMed  Google Scholar 

  18. Verbiest, H.: A radicular syndrome from developmental narrowing of the lumbar vertebral canal. J. Bone Jt Surg. 36 B (1954) 230–237.

    Google Scholar 

  19. Verbiest, H.: Further experiences on the pathological influence of a developmental narrowness of the bony lumbar vertebral canal. J. Bone Jt Surg. 37 B (1955) 576–583.

    Google Scholar 

  20. Verbiest, H.: (1975) Pathomorphologic aspects of developmental lumbar stenosis. Orthop. Clin. North Amer. 6 (1975) 177–196.

    Google Scholar 

  21. Verbiest, H.: Neurogenic Intermittent Claudication — lesions of the spinal cordand cauda equina, stenosis of the vertebral canal, narrowing of intervertebral foramina and entrapment of peripheral nerves. North-Holland Publ. Co. Amsterdam; American Elsevier Publ. Co. Inc., New York 1976.

    Google Scholar 

  22. Verbiest, H.: Fallacies of the present definition, nomenclature, and classification of the stenoses of the lumbar vertebral canal. Spine 1 (1976) 217–225.

    Google Scholar 

  23. Verbiest, H.: The significance and principles of CT axial tomography in idiopathic developmental stenosis of the bony lumbar vertebral canal. Spine 4 (1979) 369–378.

    PubMed  Google Scholar 

  24. Verbiest, H.: Sténose de croissance du canal vertébral lombaire. Encycl. Méd. Chir., Paris. Techniques chirurgicales. Orthopédie, 44181, 4-4-02 (1979) 1–6.

    Google Scholar 

  25. Verbiest, H.: Stenosis of the Bony Lumbar Vertebral canal. In: Wackenheim, A., E. Babin: The Narrow Lumbar Canal, Ch. 12, 115–146. Springer, Berlin, Heidelberg, New York 1980.

    Google Scholar 

  26. Vernon Roberts, B.: Pathology of Degenerative Spondylosis. In: Jayson, M.: The Lumbar Spine and Back Pain, Ch. 4, 55–75. Sector Publ. Limit., London 1976.

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, State University, Nicolaas Beetsstraat 24, 3500 CG, Utrecht, The Netherlands

    H. Verbiest

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  1. H. Verbiest
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Dedicated to Professor K. J. Zülch on the occasion of his 70th birthday.

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Verbiest, H. Stenosis of the lumbar vertebral canal and sciatica. Neurosurg. Rev. 3, 75–89 (1980). https://doi.org/10.1007/BF01644422

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