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Estenose da coluna vertebral

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Last reviewed: 21 Dec 2025
Last updated: 14 Dec 2021

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • início e duração dos sintomas
  • dorsalgia
  • dorsalgia relacionada a atividades físicas
  • dor nas pernas ao andar
  • postura recurvada ao andar
  • dormência nas pernas ou parestesia
  • ausência de achados nos exames
Detalhes completos

Outros fatores diagnósticos

  • dor que se irradia para as pernas
  • disfunção da bexiga ou do intestino
  • fraqueza ou desgaste muscular
Detalhes completos

Fatores de risco

  • idade >40 anos
  • trabalho manual
  • cirurgia prévia das costas
  • histórico familiar de dorsalgia
  • tabagismo
  • diabetes mellitus
  • doença vascular periférica oclusiva
  • lesão prévia
  • acondroplasia
  • acromegalia
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • radiografia simples
  • RNM (ponderada em T2)
Detalhes completos

Investigações a serem consideradas

  • mielotomografia
  • tomografia computadorizada (TC) da coluna vertebral
  • teste de marcha com eletromiografia (EMG)
  • mapeamento paraespinhal por eletromiografia
Detalhes completos

Algoritmo de tratamento

AGUDA

deficit neurológico agudo significativo

sem deficit neurológico agudo significativo: dor afetando a qualidade de vida e/ou as atividades funcionais

CONTÍNUA

sintomas crônicos

Colaboradores

Autores

Michael David Tseng MD, MD

Clinical Assistant Professor

Department of Orthopaedic Surgery

Stanford University School of Medicine

Stanford

CA

Disclosures

MDT declares that he has no competing interests.

Acknowledgements

Dr Michael David Tseng would like to gratefully acknowledge Dr Adam M. Pearson, Dr William A. Abdu, Dr John K. Houten, and Dr Mark Chwajol, previous contributors to this topic. WAA is an author of a reference cited in this topic. JKH and MC declare that they have no competing interests.

Disclosures

WAA and AMP are authors of references cited in this topic. JKH and MC declared that they had no competing interests.

Peer reviewers

John Ratliff, MD, FAANS, FACS

Associate Professor

Department of Neurosurgery

Stanford University

Stanford

CA

Disclosures

JR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982 May;(165):110-23. Abstract

Jane JA Sr, Jane JA Jr, Helm GA, et al. Acquired lumbar spinal stenosis. Clin Neurosurg. 1996;43:275-99. Abstract

Garfin SR, Herkowitz HN, Mirkovic S. Nonoperative and operative treatment of lumbar stenosis. In: Rothman R, Simeone F, eds. The spine. 3rd ed. Philadelphia, PA: WB Saunders; 1991:857-75.

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010 Jun 15;35(14):1329-38.Full text  Abstract

Zdeblick TA. The treatment of degenerative lumbar disorders: a critical review of the literature. Spine (Phila Pa 1976). 1995 Dec 15;20(24 Suppl):126S-37S. Abstract

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007 May 31;356(22):2257-70.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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  • Patient information

    Estenose da coluna vertebral

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