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Lumbar Spinal Stenosis London Spine Lumbar Stenosis

The article discusses the anatomy of the spine, including the anterior and posterior regions. The anterior spine is composed of cylindrical vertebral bodies separated by intervertebral disks, while the posterior spine consists of vertebral arches and processes. The spinal canal, formed by the vertebral bodies and arches, houses the spinal cord. The article also explains lumbar spinal stenosis, which is the narrowing of the lumbar vertebra in different areas, including the central canal, lateral recess, and neural foraminal areas. The various causes of lumbar spinal stenosis are discussed, including ligamentum flavum hypertrophy, disk bulging, facet arthropathy, osteophyte formation, and disk herniation. The condition is a significant cause of disability in older individuals and is a common indication for spinal surgery in patients over 65 years old. However, there is currently no universally accepted definition or diagnostic criteria for lumbar spinal stenosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital in London

Published article

Spine Anatomy

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Excerpt Spine Anatomy Collectively, the spine has an anterior and a posterior region (see Image. Lumbar Vertebral Anatomy). The cylindrical vertebral bodies comprise the anterior spine, separated by intervertebral (IV) disks and held in place by the anterior and posterior longitudinal ligaments. The IV disks have the gelatinous nucleus pulposus in the middle, surrounded by,

Excerpt

Spine Anatomy

Collectively, the spine has an anterior and a posterior region (see Image. Lumbar Vertebral Anatomy). The cylindrical vertebral bodies comprise the anterior spine, separated by intervertebral (IV) disks and held in place by the anterior and posterior longitudinal ligaments. The IV disks have the gelatinous nucleus pulposus in the middle, surrounded by the cartilaginous annulus fibrosus (see Image. Intervertebral Disk). The cervical and lumbar spinal segments have the largest IV disks, owing to these regions’ mobility. The anterior spine is a shock absorber of bodily movements.

The vertebral arches and processes constitute the posterior spine. Each vertebral arch has an anterior pair of cylindrical pedicles and a posterior pair of laminae (see Image. Lumbar Vertebra, Superoposterior View). Other structures emanating from the vertebral arch include 2 lateral transverse processes, 1 posterior process, and 2 superior and 2 inferior articular facets. Facet joints form from superior and inferior facet apposition. The spinal canal, which houses the spinal cord, is formed by the vertebral bodies and IV disks anteriorly and vertebral arches posteriorly. The nerve roots exit superior to their corresponding vertebral body through the intervertebral canal. The ligamentum flavum (yellow ligament) is a thick, fibrous structure passing between adjacent laminae.

The lateral recess is an anatomic space in the posterior spine bounded anteriorly by the vertebral body and disk, posteriorly by the ligamentum flavum and vertebral arch, laterally by the pedicle, and medially by the thecal sac. This region is narrow and is a potential area of nerve root compression. The posterior spine has various functions, including spinal cord and nerve root protection and muscle and ligament support.

Lumbar Spinal Stenosis

Lumbar spinal stenosis (LSS) is the narrowing of the lumbar vertebra in the central canal, lateral recess, or neural foraminal areas. Central canal stenosis may compress the thecal sac and bilateral spinal segments and thus, in the severe form, may produce bilateral symptoms. Lateral recess and neural foraminal stenosis may compress the nerve roots and produce unilateral lumbar radiculopathy symptoms.

Central stenosis arises from anterior ligamentum flavum hypertrophy compounded by posterior disk bulging. This condition is more prevalent at the L4 to L5 level than other spinal segments. Meanwhile, lateral recess stenosis results from facet arthropathy and osteophyte formation, compressing the nerve before it passes the intervertebral foramen. Foraminal stenosis is due to disk height loss, foraminal disk protrusion, or osteophyte formation. These changes impinge on the nerve root inside the intervertebral foramen. Extraforaminal stenosis is usually due to far lateral disk herniation. This condition compresses the nerve root after exiting the intervertebral foramen laterally.

LSS is a significant cause of disability in older individuals and a common spinal surgery indication in patients older than 65 years. Henk Verbiest first described relative and absolute spinal stenosis as lumbar canal midsagittal diameter of less than 12 mm and 10 mm, respectively. However, LSS clinical and radiologic diagnostic criteria have not been established despite this condition’s global prevalence. Thus, this clinical entity has no universally accepted definition.

The London Spine Unit : innovative spinal hospital in London

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Lumbar Spinal Stenosis

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Excerpt Spine Anatomy Collectively, the spine has an anterior and a posterior region (see Image. Lumbar Vertebral Anatomy). The cylindrical vertebral bodies comprise the anterior spine, separated by intervertebral (IV) disks and held in place by the anterior and posterior longitudinal ligaments. The IV disks have the gelatinous nucleus pulposus in the middle, surrounded by
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