Spinal stenosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

The symptoms of spinal stenosis usually develop in the old age, and start with symptoms such as pain and cramping in neck, back and legs. Common complications of spinal stenosis include: Numbness of limbs, Paralysis of limbs, Weakness of limbs, Obesity due lack of activity, Bladder or bowel incontinence,Depression, and other psychological problems. Prognosis in patients with spinal stenosis who initially treated with medical or physical therapy is variable. Among treated patients without surgery in one study, about 50% remain unchanged, 25% improve, and 25% worsen (mean follow-up was 49 months, range 10 to 103 months). Outcome in patients treated surgically is not significantly better rather than nonsurgically treated patients.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of spinal usually develop in the old age, and start with symptoms such as pain and cramping in neck, back and legs. [1][2]

Complications

Prognosis

  • Prognosis in patients with spinal stenosis who initially treated with medical or physical therapy is variable.[9][10]
  • Among treated patients without surgery in one study, about 50% remain unchanged, 25% improve, and 25% worsen (mean follow-up was 49 months, range 10 to 103 months).
  • Outcome in patients treated surgically is not significantly better rather than nonsurgically treated patients.[11][12]

References

  1. 1.0 1.1 1.2 1.3 1.4 Melancia JL, Francisco AF, Antunes JL (2014). "Spinal stenosis". Handb Clin Neurol. 119: 541–9. doi:10.1016/B978-0-7020-4086-3.00035-7. PMID 24365318.
  2. 2.0 2.1 2.2 2.3 2.4 Doualla-Bija M, Takang MA, Mankaa E, Moutchia J, Ongolo-Zogo P, Luma-Namme H (2017). "Characteristics and determinants of clinical symptoms in radiographic lumbar spinal stenosis in a tertiary health care centre in sub-Saharan Africa". BMC Musculoskelet Disord. 18 (1): 494. doi:10.1186/s12891-017-1844-2. PMC 5704579. PMID 29179752.
  3. Ammendolia C (2014). "Degenerative lumbar spinal stenosis and its imposters: three case studies". J Can Chiropr Assoc. 58 (3): 312–9. PMC 4139768. PMID 25202160.
  4. Knutsson B, Sandén B, Sjödén G, Järvholm B, Michaëlsson K (2015). "Body Mass Index and Risk for Clinical Lumbar Spinal Stenosis: A Cohort Study". Spine (Phila Pa 1976). 40 (18): 1451–6. doi:10.1097/BRS.0000000000001038. PMID 26165225.
  5. De Riggo J, Benčo M, Kolarovszki B, Lupták J, Svihra J (2011). "[Urinary incontinence in degenerative spinal disease]". Acta Chir Orthop Traumatol Cech. 78 (1): 67–70. PMID 21375969.
  6. Foster OJ, Harrison MJ, Crockard HA (1987). "Exercise provoked faecal incontinence in spinal stenosis". J Neurol Neurosurg Psychiatry. 50 (3): 362–3. PMC 1031810. PMID 3559621.
  7. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kröger H, Savolainen S; et al. (2006). "Depression and associated factors in patients with lumbar spinal stenosis". Disabil Rehabil. 28 (7): 415–22. doi:10.1080/09638280500192462. PMID 16507504.
  8. Tuomainen I, Pakarinen M, Aalto T, Sinikallio S, Kröger H, Viinamäki H; et al. (2018). "Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study". Spine J. 18 (3): 458–463. doi:10.1016/j.spinee.2017.08.228. PMID 28822826.
  9. Sigmundsson FG, Kang XP, Jönsson B, Strömqvist B (2012). "Prognostic factors in lumbar spinal stenosis surgery". Acta Orthop. 83 (5): 536–42. doi:10.3109/17453674.2012.733915. PMC 3488183. PMID 23083437.
  10. Matsudaira K, Hara N, Oka H, Kunogi J, Yamazaki T, Takeshita K; et al. (2016). "Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study". PLoS One. 11 (2): e0148584. doi:10.1371/journal.pone.0148584. PMC 4749385. PMID 26863214.
  11. Zaina F, Tomkins-Lane C, Carragee E, Negrini S (2016). "Surgical versus non-surgical treatment for lumbar spinal stenosis". Cochrane Database Syst Rev (1): CD010264. doi:10.1002/14651858.CD010264.pub2. PMID 26824399.
  12. Zaina F, Tomkins-Lane C, Carragee E, Negrini S (2016). "Surgical Versus Nonsurgical Treatment for Lumbar Spinal Stenosis". Spine (Phila Pa 1976). 41 (14): E857–68. doi:10.1097/BRS.0000000000001635. PMID 27128388.

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