Actualización en Estenorraquis lumbar: Diagnóstico, tratamiento y controversias.

Author
Molina, Marcelo; Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile Profesor asistente, Facultad de medicina, Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile

Wagner, Pablo; Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile. Becado del Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile

Campos, Mauricio; Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile Profesor asistente, Facultad de medicina, Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile

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http://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/863
Abstract
SPINAL LUMBAR STENOSIS. AN UPDATE Spinal lumbar stenosis is a disease that occurs mainly between the 5th and 7th decade of life and can be  congenital or acquired. The latter has many etiologies, but a degenerative cause is the most common. Stenosis is a narrowing of the spinal canal diameter caused by many factors such as bulging discs, hypertrophy of flavum ligament, facet capsule thickening and  osteophyte formation.  The classical symptom of the disease is sciatic pain, that improves with lumbar flexion and worsens with ambulation. Neurological examination is often normal and the most useful imaging test is magnetic resonance imaging (MRI). Conservative management consists in non-steroidal anti-inflammatory drugs, muscle relaxants, physical therapy and epidural – radicular infiltrations. Spinal infiltrations have a proven efficacy for pain management. A good result of this therapy predicts a favorable outcome after surgery. Surgical treatment consists in decompression with or without lumbar fusion. The addition of an arthrodesis is recommended for degenerative spondylolisthesis, correction of deformities, recurrent spinal stenosis with instability, sagittal or coronal imbalance and adjacent segment disease. 
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