{"id":5389,"date":"2023-05-29T11:52:58","date_gmt":"2023-05-29T11:52:58","guid":{"rendered":"https:\/\/medcom.ro\/?page_id=5389"},"modified":"2023-05-29T15:21:55","modified_gmt":"2023-05-29T15:21:55","slug":"stenoza-de-canal-vertebral-lombar","status":"publish","type":"page","link":"https:\/\/medcom.ro\/index.php\/stenoza-de-canal-vertebral-lombar\/","title":{"rendered":"Stenoza de Canal Vertebral Lombar"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\"><p>Stenoza spinal\u0103 este o condi\u021bie degenerativ\u0103 a coloanei vertebrale caracterizat\u0103 prin \u00eengustarea canalului vertebral prin care trec m\u0103duva \u0219i nervii spinali. \u00cengustarea canalului comprim\u0103 nervii spinali \u0219i m\u0103duva spin\u0103rii \u00een zona cervical\u0103 si toracal\u0103 \u0219i doar nervii spinali \u00een zona lombar\u0103, deoarece maduva spin\u0103rii se termin\u0103 \u00een mod normal la nivelul vertebrei L1-L2. Stenoza canalara poate fi observat\u0103 cel mai frecvent in zona lombar\u0103 si cervical\u0103.<\/p>\n<p>Stenoza spinala este cauzat\u0103 de modific\u0103ri degenerative, de uzura. \u00cen cazuri severe de stenoz\u0103, interven\u021bia chirurgical\u0103 poate fi recomandat\u0103.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-0{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-0{width:50% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img width=\"2560\" height=\"1575\" alt=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" title=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" src=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-scaled.jpg\" class=\"img-responsive wp-image-5413\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-200x123.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-400x246.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-600x369.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-800x492.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-1200x738.jpg 1200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-scaled.jpg 2560w\" sizes=\"(max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-1{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-1 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-1{width:50% !important;order : 0;}.fusion-builder-column-1 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-1{width:100% !important;order : 0;}.fusion-builder-column-1 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-1{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><img width=\"2560\" height=\"1575\" alt=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" title=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" src=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-scaled.jpg\" class=\"img-responsive wp-image-5414\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-200x123.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-400x246.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-600x369.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-800x492.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-1200x738.jpg 1200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-1-3-scaled.jpg 2560w\" sizes=\"(max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-2{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-2 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-2{width:50% !important;order : 0;}.fusion-builder-column-2 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-2{width:100% !important;order : 0;}.fusion-builder-column-2 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-2\"><p><strong><em><u>Tipuri de stenoz\u0103:<\/u><\/em><\/strong><\/p>\n<p>Mul\u021bi pacien\u021bi pot avea semne de stenoz\u0103 canalar\u0103 f\u00eera a avea simptome. C\u00e2nd simptomele apar, acestea au un debut gradual \u0219i se \u00eenr\u0103ut\u0103\u021besc \u00een timp. Ele variaz\u0103 \u00een func\u021bie de localizarea stenozei.<\/p>\n<p>\u2013\u00a0 \u00a0 \u00a0 \u00a0 <strong>Stenoza cervical\u0103<\/strong> \u2013 poate cauza amor\u021beli, parestezii (furnic\u0103turi \u00een membre) sau sl\u0103biciune \u00een m\u00e2ini \u0219i picioare. Paresteziile \u00een m\u00e2ini sunt cele mai frecvente, dar mul\u021bi pacien\u021bi raporteaz\u0103 porbleme cu mersul \u0219i echilibrul. \u00cen situa\u021bii avansate pot s\u0103 apar\u0103 simptome de ordin sfincterian cauz\u00e2nd tulbur\u0103ri la urinat, defeca\u021bie toate de cauz\u0103 neurologic\u0103.<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Stenoza lombar\u0103<\/strong> \u2013 poate cauza durere sau crampe \u00een picioare la ortostatism prelungit sau la mers; termenul des utilizat medical fiind de <em>claudica\u021bie neurogen\u0103<\/em>.<\/p>\n<p>Disconfortul dispare la a\u0219ezare sau la aplecarea \u00eenainte.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-3{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-3 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-3{width:50% !important;order : 0;}.fusion-builder-column-3 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-3{width:100% !important;order : 0;}.fusion-builder-column-3 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-2{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-3\"><p><strong><em><u>Cauze:<\/u><\/em><\/strong><\/p>\n<p>De\u0219i unii oameni se nasc cu un canal spinal \u00eengustat, la cei mai mul\u021bi, apari\u021bia \u00eengust\u0103rii se produce pe parcursul vie\u021bii ca urmare a unor cauze:<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Cre\u0219terea de os<\/strong> \u2013 leziunile de uzura din osteoartrit\u0103 pot duce la apari\u021bia unor osteofite care pot cre\u0219te \u0219i\/sau \u00eengusta canalul spinal.<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Herniile de disc<\/strong> \u2013 ruptura por\u021biunii exterioare a discului permite ie\u0219irea materialului moale din interiorul acestuia si comprimarea m\u0103duvei sau a nervilor.<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>\u00cengro\u0219area ligamentelor<\/strong> care men\u021bin coloana vertebral\u0103 \u00een pozi\u021bie prin mecanisme inflamatorii cronice locale.<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Apari\u021bia tumorilor<\/strong> \u2013 por\u021biuni de tumor\u0103 pot cre\u0219te \u00een sau \u00eenspre canalul vertebral.<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong>Traumatismele vertebrale<\/strong> \u00een cazul accidentelor rutiere sau alte accidente majore se pot produce luxa\u021bii, fracturi sau disloc\u0103ri.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-4{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-4 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-4{width:50% !important;order : 0;}.fusion-builder-column-4 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-4{width:100% !important;order : 0;}.fusion-builder-column-4 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\"><img width=\"2560\" height=\"1575\" alt=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" title=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" src=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-scaled.jpg\" class=\"img-responsive wp-image-5415\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-200x123.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-400x246.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-600x369.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-800x492.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-1200x738.jpg 1200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/LinkedIn-Post-copy-1-scaled.jpg 2560w\" sizes=\"(max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-5{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-5 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-5{width:50% !important;order : 0;}.fusion-builder-column-5 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-5{width:100% !important;order : 0;}.fusion-builder-column-5 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-3{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><style>.fusion-imageframe.imageframe-4{ margin-top : 150px;}<\/style><span class=\" fusion-imageframe imageframe-none imageframe-4 hover-type-none\"><img width=\"2560\" height=\"1575\" alt=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" title=\"STENOZA DE CANAL VERTEBRAL LOMBAR\" src=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-scaled.jpg\" class=\"img-responsive wp-image-5418\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-200x123.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-400x246.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-600x369.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-800x492.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-1200x738.jpg 1200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/05\/NEUROCHIRURGIE-3-1-scaled.jpg 2560w\" sizes=\"(max-width: 640px) 100vw, 600px\" \/><\/span><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-6{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-6 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-6{width:50% !important;order : 0;}.fusion-builder-column-6 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-6{width:100% !important;order : 0;}.fusion-builder-column-6 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-4\"><p><strong><em><u>Diagnosticul pentru stenoza de canal lombar:<\/u><\/em><\/strong><\/p>\n<p>Durerea de spate cervico-toraco-lombar\u0103 acut\u0103 sau cu caracter cronic survenit\u0103 pe fond traumatic sau spontan ori corelat\u0103 cu alt context clinic se va supune unui prim consult de specialitate si a unui set de investiga\u021bii specifice pentru elucidarea diagnosticului.<\/p>\n<ol>\n<li><u>1<strong>. Istoricul pacientului:<\/strong><\/u> Primul pas pentru diagnosticarea stenozei de canal lombar este consulta\u021bia medical\u0103. \u00cen cadrul consulta\u021biei, medicul v\u0103 face o revizuire atent\u0103 a istoricului medical adres\u00e2ndu-v\u0103 mai multe intreb\u0103ri:<\/li>\n<\/ol>\n<ul>\n<li>despre debutul problemei dvs.,<\/li>\n<li>dac\u0103 s-a \u00eenr\u0103ut\u0103\u021bit,<\/li>\n<li>dac\u0103 ave\u021bi alte probleme medicale,<\/li>\n<li>dac\u0103 exist\u0103 medicamente sau pozi\u021bii care v\u0103 amelioreaz\u0103 problemele,<\/li>\n<li>dac\u0103 ave\u021bi dureri \u0219i unde se localizeaz\u0103,<\/li>\n<li>dac\u0103 ave\u021bi probleme cu vezica urinar\u0103 etc.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong> <u> Examinare fizica:<\/u><\/strong><\/li>\n<\/ol>\n<p>Pe lang\u0103 evaluarea istoricului medical al pacientului, pentru diagnosticarea stenozei de canal lombar se efectueaz\u0103 \u0219i o examinare fizic\u0103 prin palpare a coloanei vertebrale. De asemenea ve\u021bi fi examinat clinic pentru a fi siguri ca nu exist\u0103 \u0219i alte probleme fa\u021b\u0103 de cele relatate cum ar fi claudica\u021bia neurogen\u0103 (o durere care apare la mers).<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 3.<u>Evaluarea radiologic\u0103<\/u><\/strong><\/p>\n<p>Cu toate c\u0103 istoricul pacientului \u0219i examinarea fizic\u0103 a acestuia pot sugera stenoza spinal\u0103, diagnosticul trebuie confirmat prin imagistic\u0103 medical\u0103. Simptomele prezente \u00een stenoza de canal pot ap\u0103rea \u0219i \u00een alte condi\u021bii cauzate de degenerescen\u021b\u0103 datorat\u0103 v\u00e2rstei, drept urmare evaluarea imagistic\u0103 este foarte important\u0103.<\/p>\n<ul>\n<li><strong>Radiografii<\/strong> \u2013 arat\u0103 structura osoasa a coloanei vertebrale \u0219i eventualele osteofite;<\/li>\n<li><strong>RMN<\/strong> \u2013 cea mai elocvent\u0103 evaluare imagistic\u0103. Pe sec\u021biunile foarte fine \u0219i \u00een 3 planuri anatomice, se va vedea foarte clar zona de stenoz\u0103, daca este important\u0103 sau nu \u0219i dac\u0103 sunt \u0219i alte probleme asociate ale coloanei vertebrale.<\/li>\n<li><strong>Tomografia computerizat\u0103 (CT)<\/strong> evalueaz\u0103 cu fidelitate si acurate\u021be structurile osoase fiind necesar\u0103 \u00een completarea diagnosticului.<\/li>\n<\/ul>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-7{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-7 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-7{width:50% !important;order : 0;}.fusion-builder-column-7 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-7{width:100% !important;order : 0;}.fusion-builder-column-7 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-4{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-5\"><p><strong><u>Tratamentul nonchirurgical al stenozei lombare:<\/u><\/strong><\/p>\n<p>\u00a0<\/p>\n<p>Dat fiind faptul c\u0103 aceast\u0103 entitate a fost destul de tardiv recunoscut\u0103 \u00een arealul neurologic\/neurochirurgical, modalit\u0103\u021bile de tratament au variat in limite largi, astfel c\u0103 bolnavul nu a beneficiat \u00eentotdeauna de un prim consult de specialitate, acesta a \u00eencercat tratamente de reducere a durerii, medicamente, fiziokinetoterapie fara ca s\u0103 \u0219tie dac\u0103 afec\u021biunea sa este defapt o hernie de disc exacerbat\u0103, o instabilitate vertebral\u0103 prin fenomene de listez\u0103 (alunecare a unei vertebre fa\u021b\u0103 de cea subiacent\u0103), patologie articular\u0103, neoplazic\u0103, infec\u021bioas\u0103, complementar\u0103 unei deform\u0103ri.<\/p>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n<p>In majoritatea cazurilor de stenoz\u0103 de canal lombar, aceasta poate fi tratata cu o combina\u021bie de tratamente nonchirugicale cum ar fi: kinetoterapia, tratamentele medicale, infiltra\u021biile sau modificarea activit\u0103\u021bii fizice a pacientului.<\/p>\n<p>\u00a0<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Medicamentele:<\/strong><\/p>\n<p>Medicamentele obi\u0219nuite sunt de cele mai multe ori folosite pentru a ajuta la ameliorarea durerii, relaxarea muscular\u0103 \u0219i desensibilizarea nervoas\u0103 provocat\u0103 de stenoza lombara dar nu pot trata cauza apari\u021biei durerii.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kinetoterapia<\/strong> si exerci\u021biile fizice sunt recomandate \u00een orice etap\u0103 a tratamentului. Rolul kinetoterapeutului este foarte important. \u00cen general, pacien\u021bii cu stenoz\u0103 de canal spinal scad activitatea fizic\u0103 depus\u0103 zilnic pentru a reduce durerile. Sl\u0103biciunea muscular\u0103 duce \u00eens\u0103 la \u0219i mai mult\u0103 durere. Kinetoterapeutul v\u0103 \u00eenva\u021b\u0103 exerci\u021bii ce v\u0103 vor cre\u0219te for\u021ba muscular\u0103 \u0219i rezisten\u021ba, flexibilitatea \u0219i stabilitatea coloanei vertebrale \u0219i v\u0103 vor cre\u0219te echilibrul.<\/p>\n<p>\u00a0<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Infiltra\u021biile<\/strong> sunt o resurs\u0103 valoroas\u0103 in tratamentul stenozelor canalare. R\u0103d\u0103cinile nervoase pot fi iritate \u0219i umflate \u00een locurile \u00een care sunt comprimate. Injectarea de antiinflamatorii steroidiene \u00een jurul r\u0103d\u0103cinii va ajuta la reducerea inflama\u021biei \u0219i va sc\u0103dea par\u021bial compresiunea asupra r\u0103d\u0103cinii nervoase. Totu\u0219i, infiltra\u021biile nu functioneaz\u0103 la toat\u0103 lumea, substan\u021ba terapeutic\u0103 put\u00e2nd s\u0103 se distribuie aleator \u0219i s\u0103 nu-\u0219i ating\u0103 scopul dorit.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-8{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-8 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 1.92%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 1.92%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-8{width:100% !important;order : 0;}.fusion-builder-column-8 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-8{width:100% !important;order : 0;}.fusion-builder-column-8 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-5{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-6\"><p>In cazuri rare, pacien\u021bii netrata\u021bi care au stenoz\u0103 spinal\u0103 sever\u0103 pot progresa c\u0103tre deficite permanente cum ar fi: amor\u021beal\u0103, sl\u0103biciune, tulbur\u0103ri de echilibru, incontinen\u021b\u0103 sau paralizie. C\u00e2nd stenoza spinal\u0103 duce la agravarea deficitelor neurologice, poate fi luat\u0103 in considerare interven\u021bia chirurgical\u0103 dac\u0103 tratamentele nonchirurgicale nu au fost eficiente.<\/p>\n<p>Scopul unei interventii chirurgicale de stenoz\u0103 lombar\u0103 este de a <strong>decomprima nervul spinal si\/sau a m\u0103duvii spin\u0103rii<\/strong> pentru a permite nervilor s\u0103 se vindece \u0219i s\u0103 func\u021bioneze mai bine.<\/p>\n<p>\u00a0<\/p>\n<p>De-a lungul timpului au fost stabilite scoruri neurologice de dizabilitate, de durere, de motricitate, sensitive, afectare sfincterian\u0103 etc. cu largi accep\u021biuni \u00een lumea medical\u0103 chiar din aceea\u0219i specialitate. Astfel, orice durere de spate cu un diagnostic cert \u0219i cu afectare neurologic\u0103 clar\u0103, ce nu se poate rezolva conservator, se poate supune interven\u021biei chirurgicale. Abordarea chirurgical\u0103 este indicat\u0103 cu at\u00e2t mai mult cu c\u00e2t fenomenele sunt \u00eenso\u021bite imagistic de coresponden\u021bi echivoci pentru patologii de ordin infec\u021bios, malformativ, traumatic, neoplazic, etc.; ce impun o sanc\u021biune de ordin chirurgical.<\/p>\n<p>\u00a0<\/p>\n<p>Daca contextul este cel strict degenerativ cu indicatii operatorii, aceasta se face prin cateva tehnici clar stabilite de literatura de specialitate mergand in functie de scorurile CT-RMN \u0219i clinic de la simpla <strong>Laminctomie<\/strong> cu\/f\u0103r\u0103 artrectomii par\u021biale, cu\/f\u0103r\u0103 p\u0103strare de istm vertebral \u0219i imobilizare extern\u0103 \u00een corset; \u0219i p\u00e2n\u0103 la <strong>Spondilosinteze de coloan\u0103<\/strong> argumentate pe fiecare patologie \u0219i pacient cu\/f\u0103r\u0103 fuziune intervertebral\u0103 (TLIF,OLIF,ALIF,PLIF,XLIF) sau alte proceduri mai complexe \u00een func\u021bie de gradul de deteriorare local\u0103 sau indica\u021biile stricte pentru patologia tratat\u0103, toate fiind executate sub reperaj radiologic, neuronaviga\u021bie spinal\u0103 ori chirurgie spinal\u0103 robotic\u0103.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-9{width:50% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-9 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-9{width:50% !important;order : 0;}.fusion-builder-column-9 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-9{width:100% !important;order : 0;}.fusion-builder-column-9 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column 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