Pathology - Spinal lumbar stenosis
Pathogenesis In these situations, it's critical to differentiate between neurogenic claudication and vascular claudication. Vascular claudication only needs to be stopped, whereas neurogenic claudication usually goes away with a change in posture. Furthermore, walking uphill and with hip flexion reduces the pain associated with neurogenic claudication. Neural ischemia, which is the root cause of claudication, is brought on by surrounding tissues compressing the spinal nerves. Other neurologic symptoms that patients may experience include paresthesias and incontinence. An MRI can confirm the diagnosis by demonstrating compression of the spinal nerves as they leave the spinal canal or of the spinal canal centrally. Compression of the spinal nerves can also result from herniated nucleus pulposus and bony spurs of the spine. Decompressive laminectomy is a possibility if conservative measures, such as physical therapy, neuropathic and anti-inflammatory pain drugs, and steroid injections, are ineffective.
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