Lomber spinal dar kanal ve intermittan nörojenik klodikasyon
Küçük Resim Yok
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Lomber dar kanal ve intermittan nörojenik klodikasyon, 55 yaşından sonra sık görülen ve 65 yaşından sonra klinik, radyolojik ve tedavi yönleriyle oldukça kompleks hale gelen bir hastalıktır. Bu derlemede dejeneratif osteoartrite bağlı akkiz dar kanal ele alınmıştır. Hastalıkta, bel ve bacak ağrıları, bacaklarda paresteziler sık görülmekle beraber esas hastalığı karakterize eden durum, ayakta durma ve yürüme ile bu bulguların ortaya çıkması ya da artış göstermesidir (intermittan nörojenik klodikasyon). Radyolojik görünüm tipik bir lomber dar kanal göstermesine karşın olguların 1/4 ve 1/5’inde hiçbir yakınma olmayabilir. Tanıya yardımcı olmak bakımından klinik nörofizyolojik testler hem istirahat hem de hasta aktif halde iken uygulanmıştır. Devinimi izledikten sonra elektrofizyolojik belirtilerin bazılarında bozulmalar saptanmıştır. En yararlı görülen yöntemler paravertebral ve bacak kaslarında elektromiyografide denervasyon bulguları saptanması ve H-refleks anormallikleri ile yeni radiküler uyarım teknikleriyle elde edilen bulgulardır. Elektrofizyolojik bulgular kliniğe daha uyumlu bulunmuştur. Hastaların yaşam kalitesini bozan ve konservatif tedaviden yarar görmeyen hastalarda çeşitli lomber cerrahi girişim uygulamaları söz konusudur.
Lumbar spinal stenosis and intermittent neurogenic claudication is a disease that occurs frequently after the age of 55 and becomes complicated after the age of 65 in clinical, radiological and therapeutic aspects. In this review, acquired spinal stenosis secondary to degenerative osteoarthritis is evaluated. In this disease, lumbar and extremity pain and paresthesia are frequent; however, the most characteristic feature of the disease is the occurrence and worsening of these findings with erect posture and walking (intermittent neurogenic claudication). Even though the radiological findings of spinal stenosis are apparent, 1/4-1/5 of the patients may be asymptomatic. In order to support the clinical findings, neurophysiological tests have been used at rest and motion. Certain electrophysiological signs have been found to change after motion. The most helpful signs are the denervation of paravertebral and leg muscles, H-reflex abnormalities, and the findings obtained with the recently used radicular excitation methods. Electrophysiological methods have been found to be more compatible with the clinical findings. Lumbar surgical approach is considered in patients with impaired life quality and in those unresponsive to conservative treatment.
Lumbar spinal stenosis and intermittent neurogenic claudication is a disease that occurs frequently after the age of 55 and becomes complicated after the age of 65 in clinical, radiological and therapeutic aspects. In this review, acquired spinal stenosis secondary to degenerative osteoarthritis is evaluated. In this disease, lumbar and extremity pain and paresthesia are frequent; however, the most characteristic feature of the disease is the occurrence and worsening of these findings with erect posture and walking (intermittent neurogenic claudication). Even though the radiological findings of spinal stenosis are apparent, 1/4-1/5 of the patients may be asymptomatic. In order to support the clinical findings, neurophysiological tests have been used at rest and motion. Certain electrophysiological signs have been found to change after motion. The most helpful signs are the denervation of paravertebral and leg muscles, H-reflex abnormalities, and the findings obtained with the recently used radicular excitation methods. Electrophysiological methods have been found to be more compatible with the clinical findings. Lumbar surgical approach is considered in patients with impaired life quality and in those unresponsive to conservative treatment.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Türk Nöroloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
16
Sayı
2
