CAUDA-EQUINA DYSFUNCTION - THE SIGNIFICANCE OF 2-LEVEL PATHOLOGY

被引：77

作者：

PORTER, RW

WARD, D

机构：

[1] Department of Orthopaedics, Aberdeen University Medical School, Aberdeen

[2] Departmcnt of Radiology, Doncaster Royal Infirmary

来源：

SPINE | 1992年 / 17卷 / 01期

关键词：

NEUROGENIC CLAUDICATION; SPINAL STENOSIS; ROOT CANAL STENOSIS; VENOUS POOLING;

D O I：

10.1097/00007632-199201000-00002

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The pathophysiology of neurogenic claudication is not well understood. It is generally believed that stenosis of the central vertebral canal is significant, but some believe that it is root canal stenosis or stenosis of the foramen that is important, not pathology in the central canal. There are, however, clinical anomalies incompatible with either view. In this article, 49 patients with neurogenic claudication were examined with myelography and computed tomography, recording the frequency of multilevel central canal stenosis and the presence of coexistent root canal stenosis. Of the 49 patients, 46 had either multilevel central canal stenosis or stenosis of both central and root canals. It was concluded that neurogenic claudication is generally associated with at least two levels of stenosis. A hypothesis of two-level venous compression, with venous pooling of one or several nerve roots, explains some of the pathophysiology of neurogenic claudication. This hypothesis is compatible with clinical and experimental observations, but it has yet to be confirmed.

引用

页码：9 / 15

页数：7

共 32 条

[11]

Hitsclberger W.E., Witten R.M., Abnormal myelograms in asymptomatic p atients, J Neurosurg, 7, pp. 150-158, (1968)

[12]

Johansson J.E., Barrington T.W., Ameli M., Combined v ascu lar and neurogenic claudica tion, Spine, 7, pp. 150-158, (1982)

[13]

Johnsson K.-E., Lum bar Spinal Stenosis: A Clinical Radiological and Ncurophysiological Inve Stigation, (1987)

[14]

Kirkaldy-Willis W.H., Wedge J.H., Yong-Hing K., Et al., Lum bar spine nerve lateral entrapment, Clin O Rthop, 169, pp. 171-178, (1982)

[15]

Magnaes B., Clinical recording of pressure on the spinal cord and cauda equina. Part 1: T h e spinal block infusion test: Method and clinical studies, J Neurosurg, 57, pp. 48-56, (1982)

[16]

McGuire R.A., Brown M.D., Green B.A., Intradural spinal tumours and spinal stenosis, Spine, 12, pp. 1062-1066, (1987)

[17]

Naylor A., Factors in the d eve lopment of spinal stenosis syndrome, J Bone Jo in T Surg, 6IB, pp. 306-309, (1979)

[18]

Olma Rkcr K., Spinal Nerve Root Compression: Experimental Studies on Effects of Acute, Graded Compression on Nerve Root Nutrition and Function, with an In-Vivo Compression Model of the Porcine Cauda Equina, (1990)

[19]

Olmarkcr K., Holm S., Rydevik B., More Pronounced Effecls of Double Level Compression than Single Level Compression on Impulse Propagation in the Porcine Cauda Equ in A, (1990)

[20]

Ooi Y., Mita K.F., Satoh Y., Mycloscopic study on lumbar spinal canal stenosis with special reference to intermittent claudication, Spine, 15, pp. 544-549, (1990)

← 1 2 3 4 →