Symptoms of lateral recess stenosis

In fact, there are many cases in clinical practice at present. These cases do not indicate which groups of people will be affected by this disease, but that it may occur in many groups of people. This is due to physical factors. Some people have lateral recess stenosis. There are many causes for this, but the main ones are congenital or developmental problems. Patients need to go to the hospital for reasonable examination and treatment based on the symptoms.

In some clinical cases, the patient is diagnosed with lumbar disc herniation before surgery. However, there is no herniated disc during the operation, or only a small protrusion. The main lesion is lateral stenosis of the spinal canal compressing the nerve roots, which is specifically called lateral recess stenosis to distinguish it from main spinal canal stenosis.

The lateral recess refers to the narrow space extending laterally from the spinal canal, which mainly occurs in the trilobate spinal canal and is most typical at the lower two lumbar vertebrae. It is generally believed that the anteroposterior diameter of the lateral recess less than 3mm is stenosis, more than 5mm is normal, and those in between are relatively stenosis.

Why does the lateral recess become narrow?

Congenital factors can cause lateral recess stenosis. The lateral recess of the trilobate spinal canal is deep and the anterior-posterior diameter is small, so the factors of stenosis exist from the developmental stage. Another important factor contributing to stenosis is degeneration. The intervertebral disc degenerates, the annulus fibrosus bulges and calcifies, the posterior superior edge of the vertebral body proliferates, and it protrudes from the front to the back into the lateral recess; after the intervertebral disc stenosis, the superior articular process of the lower vertebra moves upward; the isthmus proliferates, the yellow ligament thickens and calcifies, and it protrudes from the back into the lateral recess; the degenerative vertebral body slips anteriorly or posteriorly, all of which can contribute to lateral recess stenosis.

What are the symptoms of lumbar lateral recess stenosis and how to treat it?

The disease mostly occurs in middle-aged people and above, and is more common in men than in women. This may be because men bear heavier loads, the lower lumbar spinal canal is more likely to be clover-shaped, and the space around the nerve roots is small, making compression symptoms more likely to occur.

Patients generally have a long history of low back pain and pain in the waist and legs. Leg pain is often more severe than that in patients with herniated disc. Fatigue or trauma can induce pain or significantly aggravate the symptoms. Neurogenic intermittent claudication is progressive, with the claudication distance decreasing from hundreds of steps to dozens of steps, and is relieved after squatting or sitting down to rest. Lower limb pain radiates along the lumbar or sacral nerve distribution area.

Lateral recess stenosis is a condition in which the nerve root is mechanically compressed by adjacent structures and is not amenable to conservative treatment. Traction is only suitable for those with mild compression. For those who have been diagnosed, surgical treatment should be chosen to completely relieve nerve root compression. The surgical technique should be refined to avoid unnecessary expansion of decompression, so as not to affect the stability between spinal segments.