Conservative treatment for lumbar spinal canal stenosis; Indication and limitation

Abstract

Neurogenic intermittent claudication due to lumbar spinal canal stenosis (LSCS) was classified into three types: radicular, cauda equina and mixed. Patients with radicular type stenosis were treated with nerve root block (RB). Patients with cauda equina type stenosis and patients presenting with mixed type stenosis were treated with sympathetic ganglion block (SB). The results of our conservative treatment for patients with LSCS were analyzed, retrospectively. 47% of radicular type stenosis patients showed a therapeutic effect of RB. Patients with degenerative spondylolisthesis showed less effectiveness compared to the patients with spondylosis. 25% of cauda equina and mixed type stenosis patients showed therapeutic effects attributable to SB. The patients with shorter duration of symptoms showed more effectiveness. In conclusion, when we consider the type of nerve involvement, the causative disease of lumbar canal stenosis, and the duration of symptoms, RB and/or SB may be an effective conservative treatment modalities to pursue before contemplating more aggressive treatment approaches