Introduction: There are different postulates aims on explanation of the underlying mechanism of neurogenic claudication associated with lumbar spinal stenosis including compression or ischemia of the nerve roots. Contact endoscope is capable of visualizing red blood cells dynamics in the blood vessels. The method provides objective measurement of the microcirculation in the scanned region. Tha aim of the study was the assessment of the changes in the flow rate in the dural blood vessels in spinal lumbar stenosis before and after surgical decompression.
Methods: The group of 9 patients aged 40 – 65 years that underwent decompression for multilevel lumbar spinal stenosis with the measurement of the microhemodynamics of the dural vessels using contact endoscope. The images were taken before and after decompression and the microhemodynamics changes observed were matched. The erythrocyte dynamics was graded into three patterns: A: no movement B: pulsatile movement C: continuous movement
Results: Assessment of intravascular erythrocyte flow rate before decompression revealed decreased flow in all patients consistent with flow pattern A and/or B. After decompression was completed, the flow rate was significantly increased and showed continuous erythrocyte flow.
Conclusions: Our results revealed decreased dural vessels microhemodynamics in lumbar spinal stenosis that corresponded to the severity of the spinal canal narrowing.
Patient Care: The result of our research indicates compressive ischemia of the nerve roots in the stenotic spinal canal as the mechanism of the neurogenic claudication - that implicates surgical decompression as the measure of revascularisation and enhancing the blood supply to the ischemic nerve roots, thus prompting the decision on decompressive surgery (the oral presentation will include the video record of the diferent flow dynamics in blood vessels as mentioned in section: Methods)
Learning Objectives: To contribute to the understanding and explanation of the possible underlying patophysiology mechanisms of the neurogenic claudication, through objective measurement of the blood vessels flow in the stenotic spinal canal segments