alexa Surgical Experience in Cases of L5 and S1 Symptoms Caused by Upper Lumbar Spinal Stenosis of L2 - L3 and L3 - L4
ISSN: 2165-7939

Journal of Spine
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Research Article

Surgical Experience in Cases of L5 and S1 Symptoms Caused by Upper Lumbar Spinal Stenosis of L2 - L3 and L3 - L4

Yawara Eguchi1*, Seiji Ohtori1, Tomoaki Toyone2, Tomoyuki Ozawa2, Kazuyo Yamauchi1, Masaomi Yamashita1, Takana Koshi1, Gen Inoue1, Munetaka Suzuki1, Sumihisa Orita1, Hiroto Kamoda1, Gen Arai1, Tetsuhiro Ishikawa1, Masayuki Miyagi1, Yasuchika Aoki3 and Kazuhisa Takahashi1
1Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
2Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
3Department of Orthopedic Surgery, Toho University Sakura Medical Center, Chiba, Japan
Corresponding Author : Yawara Eguchi, MD, PhD
Department of Orthopaedic
Surgery, Graduate School of Medicine
Chiba University, 1-8-1 Inohana, Chuoku
Chiba, 260-8670, Japan
Tel: +81-43-226-2117
Fax: +81-43-2116
E-mail: [email protected]
Received November 10, 2011; Accepted December 16, 2011; Published December 19, 2011
Citation: Eguchi Y, Ohtori S, Toyone T, Ozawa T, Yamauchi K, et al. (2012) Surgical Experience in Cases of L5 and S1 Symptoms Caused by Upper Lumbar Spinal Stenosis of L2–L3 and L3–L4. J Spine 1:105. doi:10.4172/2165-7939.1000105
Copyright: © 2012 Eguchi Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Object: Previous reports have indicated that the level of lumbar spinal canal stenosis (LSCS) often differs from that diagnosed from neurological symptoms, and L5 nerve roots are often affected by stenosis at the L2–L3 or L3–L4 level; however, few cases have been describ

Decompression surgery for upper lumbar spinal canal stenosis (LSCS) of L2–L3 and L3–L4 causing L5 and S1 symptoms was investigated.

Methods: Eight patients with a diagnosis based on L5 or S1 symptoms, but whose MRI or CT-myelography showed only one level of stenosis at L2–L3 or L3–L4 were studied. The level of stenosis was determined by the most narrowing lesion, such as total or subtotal block on CT-myelography and MRI. Selective nerve root block was performed to determine which nerve root was the origin of the pain in these patients. One-level decompression surgery at L2–L3 or L3–L4 was performed in 8 patien

Results: There were 2 cases of stenosis at L2–L3 and 6 cases at L3–L4. The level involved suggested by neurological symptoms was L5 in 6 cases and S1 in 2 cases. L5 symptoms were most often affected by L3–L4. Symptoms in all patients disappeared after one-level decompression sur

Conclusions: Degenerative stenosis of upper levels such as L2–3 and L3–4 involved damage in lower nerve roots such as L5 or S1, and L5 symptoms were most often affected by L3–L4. Decompression surgery for upper- level stenosis improved symptoms in all patients. Physicians should be aware that upper-level stenosis can cause radiculopathy at a lower level.

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