scholarly journals Analysis of Dynamic Plantar Pressure before and after the Occurrence of Neurogenic Intermittent Claudication in Patients with Lumbar Spinal Stenosis: An Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Wei Wei ◽  
Chao Xu ◽  
Xiao-Jiang Yang ◽  
Chang-Bo Lu ◽  
Wei Lei ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Plantar Pressure ◽  
Control Group ◽  
Common Disease ◽  
Neurogenic Intermittent Claudication ◽  
Pressure Distributions ◽  
Before And After ◽  
Lumbar Spinal

Lumbar spinal stenosis (LSS) is a common disease in the elderly population; it has been reported that patients with LSS have an abnormal gait pattern due to symptom such as neurogenic intermittent claudication (NIC); however, no detailed reports exist on the plantar pressure distributions in LSS patients with NIC. To analysis the plantar pressure characteristics of LSS patients, the Footscan® pressure system was used to perform dynamic plantar pressure measurements in 20 LSS patients (age, 69.5±7.2 years) before and after the occurrence of NIC. The contact time (CT), foot progression angle (FPA), pressure-time integral (PTI), and contact area (CA) were collected and compared between the LSS patients and age-matched healthy subjects in each measurement. The LSS group showed an increase in forefoot CT%, PTI, and CA% in both measurements compared with those in the control group. After the occurrence of NIC in the LSS group, CT%, PTI, and CA% of the forefoot increased further compared with those before the occurrence of NIC. In addition, after the occurrence of NIC, the PTI and CA% of the forefoot shifted from the medial foot to the lateral foot. The results suggested that the plantar pressure distributions of patients with LSS differs from normal subjects due to the posture of waking with lumbar forward flexion, and the forefoot bears a higher relative load. In addition, the occurrence of NIC could affect the plantar pressure distribution of the patients with LSS, predicting the patient’s risk of falling to the anterior direction and to the symptomatic side.

Modified fenestration with restorative spinoplasty for lumbar spinal stenosis

2009 ◽  
Vol 10 (6) ◽  
pp. 587-594 ◽  
Author(s):  
Ko Matsudaira ◽  
Takashi Yamazaki ◽  
Atsushi Seichi ◽  
Kazuto Hoshi ◽  
Nobuhiro Hara ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Canal ◽  
Spinous Process ◽  
Easy Access ◽  
Facet Joints ◽  
Neurogenic Intermittent Claudication ◽  
Lumbar Spinal

The authors developed an original procedure, modified fenestration with restorative spinoplasty (MFRS) for the treatment of lumbar spinal stenosis. The first step is to cut the spinous process in an L-shape, which is caudally reflected. This procedure allows easy access to the spinal canal, including lateral recesses, and makes it easy to perform a trumpet-style decompression of the nerve roots without violating the facet joints. After the decompression of neural tissues, the spinous process is anatomically restored (spinoplasty). The clinical outcomes at 2 years were evaluated using the Japanese Orthopaedic Association (JOA) scale and patients' satisfaction. Radiological follow-up included radiographs and CT. Between January 2000 and December 2002, 109 patients with neurogenic intermittent claudication with or without mild spondylolisthesis underwent MFRS. Of these, 101 were followed up for at least 2 years (follow-up rate 93%). The average score on the self-administered JOA scale in 89 patients without comorbidity causing gait disturbance improved from 13.3 preoperatively to 22.9 at 2 years' follow-up. Neurogenic intermittent claudication disappeared in all cases. The patients' assessment of treatment satisfaction was “satisfied” in 74 cases, “slightly satisfied” in 12, “slightly dissatisfied” in 2, and “dissatisfied” in 1 case. In 16 cases (18%), a minimum progression of slippage occurred, but no symptomatic instability or recurrent stenosis was observed. Computed tomography showed that the lateral part of the facet joints was well preserved, and the mean residual ratio was 80%. The MFRS technique produces an adequate and safe decompression of the spinal canal, even in patients with narrow and steep facet joints in whom conventional fenestration is technically demanding.

scholarly journals The efficacy of lumbar sympathetic nerve block for neurogenic intermittent claudication in lumbar spinal stenosis

2013 ◽  
Vol 27 (3) ◽  
pp. 159
Author(s):  
Masataka Ifuku ◽  
Eiichi Inada ◽  
Masako Iseki ◽  
Shuji Komatsu ◽  
Yoshihito Morita ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Nerve Block ◽  
Lumbar Spinal Stenosis ◽  
Sympathetic Nerve ◽  
Neurogenic Intermittent Claudication ◽  
Lumbar Spinal

scholarly journals Application of X STOP Device in the Treatment of Lumbar Spinal Stenosis

2010 ◽  
Vol 5;13 (5;9) ◽  
pp. E27-E336
Author(s):  
Xiaobin Yi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Extremity ◽  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Low Back ◽  
Neurogenic Intermittent Claudication ◽  
Lower Extremity Pain ◽  
Lumbar Spinal

Low back pain is exceptionally ubiquitous, complex, and costly. Nevertheless, lumbar spinal stenosis (LSS) with neurogenic intermittent claudication (NIC) is a frequent cause of low back and lower extremity pain. Although the phenomena and pathophisiology of lumbar spinal stenosis has been described for decades, therapeutic treatment options remain considerably limited. Current care consists of conservative measures including physical therapy, rest, medications, and epidural steroid injection therapy or invasive surgical treatment including laminectomy with or without fusion. Despite standard of care intervention, many patients are often left inadequately treated and suffer from debilitating low back and lower extremity pain as a result of lumbar spinal stenosis. Interspinous process distraction (IPD) devices were originally described in the 1950s, but technological advances, which have contributed to improved safety and efficacy, have rekindled an interest in IPD implantation. By mimicking lumbar flexion at affected levels of stenosis, it is thought these devices decompress neural structures within the neural foramina and therefore provide pain relief. X-STOP is one such device that is currently approved in the United States for the treatment of mild to moderate NIC resulting from LSS. This manuscript presents a focused review of NIC and LSS and comprehensively presents literature related to the use of the X-STOP IPD device. Key words: Interspinous process distraction (IPD), X STOP, interspinous spacer (ISS), lumbar spinal stenosis (LSS), neurogenic intermittent claudication (NIC), low back pain, sciatica

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