2018, Number 1
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ABSTRACTLumbar spinal stenosis (LES) is defined as the narrowing of the canal through which the neurological and vascular structures pass at the level of the lumbar spine. It is estimated that by the year 2025, approximately 64 million adults over the age of 65 in the U.S. will present clinical data of this pathology. The most common clinical data are pain referred to the buttocks, with irradiation to pelvic limbs, without the presence of pain in the lower back being necessary, most of the studies analyzed use pain and disability rating scales, the condition is aggravated by standing, walking or lumbar extension and is relieved by flexion, sitting or reclining. Options for medical treatment include medications, physical therapy, spinal injections, lifestyle modification, and rehabilitation. Patients with moderate symptoms rarely show deterioration. Surgical decision making in lumbar spinal stenosis involves evaluation of the clinical parameters and severity of the radiological stenosis, such as motor weakness, male sex, morphological stenotic grade, and amount of disability. Typical neurogenic claudication, severe pain/disability, and pronounced constriction of the spinal canal are considered the most important indications for surgical treatment in most patients, as well as horsetail symptoms and degenerative spondylolisthesis/scoliosis, were prognostic factors associated with the indication of surgery in patients with LES.
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