This topic will focus on the spinal stenosis pathophysiology of the intraspinal (central) lumbar canal. This condition, most commonly caused by degenerative bone disease, is increasingly recognized as a cause of disability in the aging population. But before that, Daily Human Care will tell little about Pathophysiology and Spinal Stenosis first.
Table of Contents
Pathophysiology
The disordered physiological processes associated with disease or injury.
Spinal Stenosis
Spinal stenosis is one of the elderly people’s most common diseases. It is known as a vertebral canal narrowing. The term stenosis derives from the Greek word ‘stenos,’ meaning narrow which was attributed to Antoine Portal in 1803, the first mention of the disease. Verbiest is credited for the coating of the word spinal stenosis and the related reduction of the spinal canal as a potential cause. The degenerative cascade of the lumbar spine was later identified by Kirkaldy-Willis as the cause of altered spinal stenosis anatomy and pathophysiology of spinal stenosis.
The spine can be narrowed in the central canal, lateral recess, or foramen, which causes neural elements to be compressed in those areas. The resulting symptoms differ with neural compression position. Neural compression in the central canal contributes to the most often observed clinical occurrence of low back pain in bilateral legs. Patients usually define the loudness and weakness in their legs that gets worse by ambulation and improves by leaning forward or leaning back. with an aged spine degeneration is caused by changes in the anatomical pathway, which causes the spinal conduit to decrease slowly or steadily.
The term spinal stenosis refers to an age-related anatomical diagnosis that may occur in asymptomatic persons. The precise cause of those of these symptoms is not well known and some have no symptoms. These presentation variations can be due to individuals’ different abilities to compensate for anatomical changes. If symptoms occur, they typically occur on the basis of the neural compression position. Neurogenic claudication is usually present in patients with central canal stenosis, while radical pain occurs in those with a lateral recess and foraminal stenosis. Often surgical care is chosen in patients whose severe symptoms do not lead to conservation therapy. In fact, the most common cause of lumbar spinal surgery is spinal stenosis in adults over 65.
Lumbar spinal stenosis (LSS)
One or more of the following anatomical states may be referred to as “Lumbar Spinal Stenoses (LSS):
- Reduction of the central (intraspinal) channel
- Lateral recess contraction
- Tightening the neural foramen
Lumbar spinal stenosis is a degenerative disease where space is reduced, secondary to degenerative changes in the spinal canal of the neural and vascular elements in the lumbar spine.
The buttock, thighs, or legs can be infected by radiating pain and numbness, particularly during the walk for a long time. When a patient sits, sits, or bends forward the pain usually decreases.
Lumbar spinal stenosis is associated with aging, mainly affecting people over 60 years of age.
The word “spinal stenosis” refers to symptoms of pain and does not indicate the symptoms of narrowing itself.
Despite its prevalence, the definition of lumbar spinal stenosis is currently not universally accepted and the general diagnostic criteria are lacking. Lumbar spinal stenosis is a major cause of elderly disability in patients older than 65 years of age and is the leading cause of spinal surgery.
Learn more about spinal stenosis, here.
Spinal Stenosis Pathophysiology
The spinal stenosis pathophysiology is linked to cord dysfunction induced by mechanical compression and degenerative instability. As the intervertebral disc ages, it degenerates and collapses and induces spurring. This occurs most frequently with C5-6 and C6-7. At this stage, there is a relative decrease in spinal movement, with a consequent increased spinal movement at C3-4 and C4-5.
The spine reacts to physiological stress with upper and lower ranges of the vertebral body’s bone development (osteophytes). Anteriorly or later, osteophytes can grow. The osteophytes in the back decrease in the intra-spinal diameter and cause stenosis laterally. This leads to impaction of the spinal cord or root nerve. In addition, arthritic degeneration induces the development of synovial cysts and facet joints hypertrophy, further impacting the patentability of the spinal canal and the neural foramina.
Spinal stenosis pathophysiology of the spinal cord results from a gradual decrease in central and lateral spinal recesses. The basic content of the spinal canal is the spinal cord, the thecal sac’s cerebrospinal fluid (CSF) and the dural membranes covering encloses the thecal bag. Without preoperative surgery, a tumor or infection, bloating or the protrusion of the intervertebral disco annulus may narrow the spinal canal, subsequent herniation of the nucleus, longitudinal ligament thickening, hypertrophy, ligament flavum hypertrophy, epidural fat deposition, intervertebral disc margin spondylosis, unconvertible discs, or other intervertebral discs.
The degeneration and irregular movement result in dysfunctional anti-persistent or retrolisthesis (subluxation of vertebral bodies out of the normal cervical alignment). The cord is compressed in C5-6 and C6-7 by spur shaping it and in C3-4 and C4-5 by listhesis. This also comes along with post-canal compromises due to hypertrophy of the ligament flavum.
The string is further weakened during regular neck movements by repeated dynamic damage. These static and dynamic compressive forces in the string contribute to spinal cord damage and myelopathic clinical syndrome.
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