腰椎管狭窄症Symptoms

The classic presentation of lumbar spinal stenosis is leg pain that increases while walking, standing, or bending backward.^1，2The pain is typically relieved in 5 to 10 minutes by sitting down or leaning forward at the waist by resting on a counter, walker, or the handle of a shopping cart.^1-3在站立和/或行走，以减少腿部疼痛甲稍微弯曲的姿势，也可以采用。¹

In the initial stages of spinal stenosis, a feeling of discomfort, cramping, and/or achiness may develop in the legs after a long walk or prolonged standing. These symptoms may then resolve after sitting, resting, or bending forward. In this stage, activities such as walking outdoors or at a store may cause symptoms. Over time, the pain may become more severe and occur at frequent intervals or remain constant, resulting in leg pain while walking inside the house/apartment.

看Video: Is Spinal Stenosis Causing My Leg Pain?

The symptoms and signs of lumbar spinal stenosis vary depending on the extent of nerve compression and the type of neural tissue affected. While spinal nerve root compression is usually more common, the spinal cord and/or cauda equina may also be compressed due to spinal stenosis. It is also possible for this condition to produce no symptoms or signs.⁴

椎管狭窄的类型

取决于神经压缩的位置，一般有两种类型的脊椎狭窄-椎间孔狭窄，从而影响脊柱神经，和中央管狭窄，这会影响脊髓和/或马尾的。

椎间孔狭窄
This type of stenosis is more common and affects an intervertebral foramen, a short bony canal through which a spinal nerve exits the spinal cord. The part of the nerve where compression occurs is called the nerve root.

椎间孔狭窄可在一个或多个以下3个方面的导致压迫神经根：

1. Just before it reaches the intervertebral foramen (lateral recess stenosis)
2. 在椎间孔
3. 离开椎间孔后不久（远外侧狭窄）

在大多数情况下，下腰椎运动节段易于退行性椎间孔椎管狭窄。^五

中央椎管狭窄
这种类型的狭窄影响椎骨的中心椎孔-的大开口。椎椎间孔一起形成椎管，其容纳在所述上腰部区域（L1-L2）和在中部和下部区域腰部的马尾神经脊髓。当椎孔变窄，其可以压迫脊髓和/或取决于受影响的椎骨的位置马尾。

了解更多关于中央管狭窄症

这是可能的椎间孔和中央管狭窄到一起发生，导致发生的两个条件的症状。lpl竞猜外围⁶

Symptoms of Lumbar Spinal Stenosis

根据不同的类型，症状和腰椎管狭窄症的症状可局限于特定区域的一条腿或影响双腿在同一时间。如果坐骨神经根被压缩，症状被称为坐骨神经痛（或神经根病）和典型地影响下背部，臀部，大腿，小腿，以及可能的脚。

引起椎管狭窄腿痛趋于决心当脊柱向前弯曲，因为这个动作打开了狭窄的运河，暂时缓解神经压迫。

椎间孔腰椎椎管狭窄的症状
Compression of a lumbar spinal nerve as it enters, courses through, or exits the intervertebral foramen may cause some combination of the following symptoms and signs:

• 根性疼痛，它起源于腰椎的来源和沿受累神经的路径行进。通常根性痛的特征在于一个或多个以下^7，8：
  • 夏普，烧灼和/或在腰背部，大腿，小腿疼痛拍摄，和/或脚
  • 在较低的背部，臀部，骨盆后方和/或背面和侧面大腿钝痛，酸痛
  • 抽筋的腿和脚
  • The pain may occur with prolonged standing or during activities, such as walking or bending the spine backward.⁹

  阅读更多神经根，神经根炎和根性疼痛

• 感觉丧失，such as numbness, pins-and-needles, and/or tingling in one or more parts of the thigh, leg, and foot.^7，8
• 弱点of the leg muscles, making it difficult to move the leg and/or foot in different directions.^6，7
• 足下垂，which occurs if the L5 spinal nerve root is compressed and results in the inability to lift the front part of the foot.¹⁰

  看到什么是足下垂？

• Stiffness在后腰。⁸

由于椎间孔椎管狭窄影响在左，右或脊柱右侧神经根，症状感到左或右小腿，沿受累神经的路径。

Lumbar central canal stenosis symptoms
When the spinal cord and/or the cauda equina nerves are compressed due to the narrowing of the internal portion of the vertebral foramen, one or more of the following symptoms may occur, typically following a symmetrical pattern in both legs:

• 神经性跛行，描述一组特征为灼痛和在臀部，大腿，小腿和痉挛，同时静置的时间和/或行走长时间症状的术语。人们体验神经性跛行的沉重和疲惫的双腿的感觉，难以提升/运动腿走路的同时。
• 感觉异常，such as tingling and/or a pins-and-needles feeling in both legs.¹¹
• 弱点，导致不能移动或抬起腿。¹¹
• Gait problems通常涉及不稳定的，基于宽的行走模式（与腿宽分开步行）。¹¹
• 困难的平衡due to the feeling of not being sure-footed.¹²

了解更多关于中央管狭窄的症状

脊髓或马尾渐进压缩可引起脊髓圆锥综合征或马尾综合征，造成腿，肠和膀胱功能的丧失。立即就医需要手术解压缩这些神经组织，防止永久性神经损伤。

腰椎管狭窄症的症状可能会有智慧h some periods of more severe symptoms and some with fewer or none. The symptoms may or may not progress over time. The severity and duration of lumbar stenosis symptoms vary between individuals and often dictate whether非手术治疗or脊柱外科更适合。

References

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• 8。迪希J.获得性腰椎管狭窄症。杂志医师助理的美国学院的。2015; 28（4）：19-23。DOI：10.1097 / 01.jaa.0000462052.47882.fd
• 9。Yamada K, Aota Y, Higashi T, et al. Lumbar foraminal stenosis causes leg pain at rest. Eur Spine J. 2014;23(3):504–507.DOI：10.1007 / s00586-013-3055-3
• 10。史蒂文斯楼Weerkamp NJ，卡尔斯JWL。脚下降。BMJ。2015; 350（apr27 6）：h1736-h1736。doi:10.1136/bmj.h1736
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• 12。Thornes E, Robinson HS, Vøllestad NK. Dynamic balance in patients with degenerative lumbar spinal stenosis; a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):192. Published 2018 Jun 15.DOI：10.1186 / s12891-018-2111-X