ABSTRACT
Decompression usually relieves leg pain and enables the patient to walk normal distances. Some back pain may remain. This is often helped by a light elastic support. If there was loss of sensation and motor power before operation, return may be considerable. The operation is only a small part of the total treatment of spinal stenosis. By relieving the pressure on nerves and blood vessels, it paves the way for the postoperative measures previously outlined. These are aimed at rebuilding atrophied muscles and restoring movement to stiff joints. We emphasize the importance of dealing not only with central stenosis involving the central canal, but also of making certain that there is no compression of the spinal nerves in their canals as they pass out through the foramina.
Subject(s)
Lumbar Vertebrae/surgery , Spinal Canal/surgery , Adult , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Humans , Postoperative Care , Spinal Diseases/etiology , Spinal Diseases/surgery , Spinal Fusion , Spondylolisthesis/complicationsABSTRACT
Correlated pathological and myelographic observations suggest that the combined types of lumbar spinal stenosis appear to be the most common. The posterior articular processes play the greatest part in producing narrowing--the inferior facet narrowing the central canal and the superior facet narrowing the nerve root canal.
Subject(s)
Lumbar Vertebrae/pathology , Spinal Canal/pathology , Arthritis/complications , Constriction, Pathologic/congenital , Constriction, Pathologic/diagnostic imaging , Constriction, Pathologic/etiology , Constriction, Pathologic/pathology , Humans , Lumbar Vertebrae/diagnostic imaging , Radiography , Spinal Canal/diagnostic imaging , Spinal Diseases/congenital , Spinal Diseases/diagnostic imaging , Spinal Diseases/etiology , Spinal Diseases/pathologyABSTRACT
The response of skeletal muscle to ischemia or trauma is similar whatever the mechanism of injury. Muscle has much more inherent ability to regenerate than has been recognized in the past. The extent of muscle damage is proportional to the duration and severity of the ischemic process. Circulation to ischemis muscle must be re-established as soon as possible. Early decompression of the appropriate compartemnts is an essential part of this procedure. No attempt should be made to excise muscle of doubtful or unknown viability during the initial decompression operation.
