Spinal stenose
Sist revidert:
Sist revidert av:Rune Midgard
Definisjon:
En innsnevring i spinalkanalen med risiko for trykk mot medulla spinalis (ved cervikal eller thorakal spinal stenose) eller nerverøtter (lumbalt)
Forekomst:
Hyppig tilstand hos voksne. Symptomatisk spinal stenose opptrer oftest hos eldre personer over 65 år
Symptomer:
Kan være asymptomatisk. Kardinalsymptomene er ryggsmerte eller ubehag under gange eller i stående stilling, som stråler ut i sete og ned i lår, legg eller føtter (nevrogen claudicatio). Ofte økende symptomintensitet ved gange nedover bakke der ryggen ekstenderes og lumbale plassforhold blir trangere. Bedring i sittende stilling
Funn:
Nevrologiske funn er sjeldne, noe fremoverlutet holdning under gange
Diagnostikk:
Aktuelle tilleggsundersøkelser er MR og CT
Behandling:
Konservativ behandling i de fleste tilfeller: informasjon, manuell terapi, fysioterapi, ev. akupunktur. Ev. med. behandlingsforsøk med SNRI eller trisyklisk antidepressivum. Tradisjonelle analgetika frarådes. Kirurgisk behandling kan vurderes ved uttalte symptomer som ikke responderer på konservativ terapi
- Nasjonal kompetansetjeneste for kirurgisk behandling av rygg- og nakkesykdommer - nettside
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- Rune Midgard, dr. med., overlege og førsteamanuensis II emeritus, NTNU
- Tor Andre Johannessen, lege og redaktør NEL
Tidligere fagmedarbeidere
- Espen Dietrichs, professor og avdelingsoverlege, Universitetet i Oslo og Nevrologisk avdeling, Rikshospitalet, Oslo