[The pathogenetic factors for neurogenic intermittent claudication caused by degenerative lumbar spinal stenosis]

The pathogenetic factors in 89 patients with typical neurogenic intermittent claudication caused by lumbar spinal stenosis were studied retrospectively. 75 patients had degenerative lumbar spinal stenosis, and 67 had unilateral nerve root canal stenosis. In most patients, the stenotic location was found at the entrance zone of nerve root canal (75/89), involving only a single level (60/89) mostly at L4.5. The pathogenetic factors for degenerative lumbar spinal stenosis were degenerative changes of lumbar disc only (55/89), and those for hypertrophy of facet joints (22/89), thickened ligamentum flavum (11/89), and spondylolis thesis (10/89). All patients were operated on: 57 of them had less invasive procedures. The excellent and good early follow-up results were noted in 73% of the patients (65/89). The authors emphasized that the surgical treatment of lumbar spinal stenosis should be as less invasive as possible rather than a tranditional extensive lumbar laminectomy.