Lumbar Stenosis

Overview

腰椎管狭窄症是指下背部椎管狭窄, or lumbar area, characterized by radiating pain, numbness or weakness in the lower back, buttocks, legs and feet.

This narrowing of the spinal canal occurs when bone or tissue, or both, grow and reduce the openings in the spinal bones, and then squeeze and irritate the spinal cord nerves.

Our Approach to Lumbar Stenosis

加州大学旧金山分校是全国最大的致力于评估和治疗脊柱疾病的中心之一, such as lumbar stenosis. 患者有机会获得最新的诊断成像技术以及创新的治疗方法，而这些技术并不普遍. Our team includes world-renowned specialists in neurosurgery, orthopedic surgery, neurology, pain management, physical therapy, psychiatry, radiology and rheumatology. 这些专家一起为每个病人制定个性化的计划.

腰椎管狭窄症的治疗最初侧重于减轻相关的下背部疼痛. The plan may include a rest period, pain medications, physical therapy, posture adjustments and weight management. 对这些治疗无效的患者可能需要手术拓宽椎管. 我们的团队在最先进的手术修复和康复方面的专业知识缩短了麻醉时间, faster recovery and, ultimately, a better quality of life.

Awards & recognition

Among the top hospitals in the nation
One of the nation's best for orthopedic care

Signs & symptoms

通常，患有腰椎管狭窄症的人会有不同程度的腰痛.

疼痛通常发生在活动时，走路时可能会加重, standing or leaning backward. 当休息、坐着或向前弯曲时，疼痛会有所缓解.

其他症状通常出现在下背部、臀部、腿部和脚，包括:

Cramping
Numbness
Stiffness
Weakness

在严重的情况下，这种情况会影响尿失禁和性功能.

Diagnosis

Doctors use two kinds of tests to diagnose spinal stenosis. 一些测试旨在确保没有其他原因引起症状. 其他可以表明椎体狭窄已经发生. After asking you questions about your symptoms, your doctor probably will check your reflexes, gait and other indicators of spinal problems.

Tests include:

X-ray High-energy radiation is used to take pictures of the spine.
Magnetic Resonance Imaging (MRI) 核磁共振成像可以提供脊柱的详细图像，这些图像是由与计算机相连的强力磁铁产生的.
Computed Tomography (CT) Scan CT扫描使用细x射线束围绕脊柱区域旋转. 计算机处理数据以构造三维的横截面图像.
Myelogram 这是一种特殊染料注入脊柱后拍的脊椎x光片. 它可以显示脊髓受压或椎间盘或椎骨有问题.

Treatments

狭窄的最初治疗是治疗症状，而不是治疗病情本身. These treatments include:

如阿司匹林或布洛芬等减轻炎症和疼痛的药物
Rest
Physical therapy
Posture changes, 比如躺着的时候膝盖收到胸部，或者走路的时候身体前倾, may relieve the pressure on the nerves
Losing weight
注射皮质类固醇以减轻炎症和疼痛
A cervical collar

If several months of treatment have not improved the symptoms, and if the stenosis is severe, surgery to widen the spinal canal may be necessary. Because bone continues to deteriorate, 即使手术成功，也可能需要几年的额外治疗. Operations used to treat stenosis include:

Anterior Cervical Discectomy and Fusion 颈部前方的一个小切口用于进入脊柱上部. 将破裂或突出的椎间盘取出并用小骨塞代替, which eventually grows to connect the two adjacent vertebrae.
Cervical Corpectomy 切除部分椎体和椎间盘，用骨移植物或金属板和螺钉来支撑脊柱.
Decompressive Laminectory 椎骨的顶部，称为椎板，通过手术切除. 手术也可能包括切除部分椎间盘或融合椎骨(脊柱融合)。.
Foramenotomy 神经根离开椎管的区域，称为椎间孔，被切除. 该手术可通过内窥镜微创入路进行, 一种能让外科十大赌博平台排行榜通过一个小切口看到身体内部的仪器. 然后外科十大赌博平台排行榜可以使用其他微小的切口来进行手术, 避免了使用大切口的传统开放技术带来的不适和肌肉萎缩.
Laminoplasty 颈部后部的受压骨被轻轻从脊髓上抬起，在脊髓和神经根上形成一个新的“屋顶”. 该手术有效地对多个节段的脊髓进行减压，而不需要融合或硬体. 它还可以最大限度地减少传统椎板切除术可能导致的脊柱不稳定或畸形的机会.
Laminotomy Only a small portion of the lamina is removed.
Medial Facetectomy 椎管中被称为关节面的部分骨结构被移除.
Cervical Disc Replacement 一项新技术将在加州大学旧金山分校医学中心进行临床试验. Instead of fusing the affected area, 用金属和塑料假体代替天然椎间盘材料，以维持或恢复运动节段. 这有望防止下一椎间盘退变.