Spinal Stenosis

Spinal Stenosis

What is Spinal Stenosis ?

Stenosis of the spine, or spinal stenosis, is a condition in which a portion of the spinal column gets narrowed, which in turn adds to the tension on the spinal cord or the spinal nerves that originate from there.

This can be a very painful condition; the pain is because of the spinal column constricting upon the cord. Though the constriction can occur at any place along the spinal column, the areas where this is most prominently experienced is in the upper back or the lower back area.



What Are the Symptoms of Spinal Stenosis ?

The excruciating pain in the region where the compression is present is the most important symptom. However, this pain can also radiate to the legs, arms and shoulders, where it can also cause a numb feeling. When the pain occurs, the person might suffer from a lack of tactile inputs and outputs.

If the pain continues, it can manifest itself in other ways. There might be erratic bowel and bladder activity. Incontinence might occur. The person may also lose equilibrium of the body and become imbalanced.

Why Does It Occur ?

The main reasons are because of a herniated disk or because of changes in the ligaments that hold the vertebrae together. In some cases, abdominal tumors might also exert pressure on the spinal column and cause it to press the spinal cord in turn.

Certain injuries and illnesses can also cause spinal stenosis. Some diseases that can cause this condition are the Paget Disease and a genetic disorder known as achondroplasia.

Diagnosis

The doctor may use a variety of approaches to diagnose spinal stenosis and rule out other conditions.

  • Medical History
  • Physical examination
  • X-Ray
  • MRI
  • Computerized Axial Tomography (CAT) or CT Scan
  • Myelogram
  • EMG/NCS

Conservative Treatments

These conservative treatments may not suffice in long-term:

  • Over the counter analgesic anti inflammatory drugs
  • Corticosteroid injections
  • Anesthetic injections, known as nerve blocks and epidurals
  • Restricted activity (varies depending on extent of nerve involvement)
  • Physical therapy
  • A lumbar brace
  • Chiropractic treatment
  • Acupuncture

Surgical Options

Microsurgical decompression by:

  • Flavectomy
  • Foraminotomy
  • Laminotomy
  • Laminoplasty
  • Nucleotomy in primary discogenic stenosis
  • Artificial Disc Replacement in primary discogenic stenosis
Dynamic Dorsal Spine Stabilization by:
  • Interspinous devices
  • Non-fusion pedicle screw systems


Surgery Risks

All surgery carries risks from anesthesia, blood clots and infections. If complications from these risks arise, they most often can be successfully treated. The physical condition of the patient (such as obesity and diabites) can also add risk to surgery.

In elderly patients, as frequent in spinal stenosis, these general risks can best be addressed by seeking a very minimally invasive approach and instrumentation. Such as combining microsurgical decompression with an interspinous device.

Surgery Long-Term Outlook

The right surgical properly executed will provide long term relief for the spinal stenosis treated. Of course, if the condition was allowed to continue too long, there may be remaining pain or numbness due to nerve damage already present. So one should not wait too long.

Treating spinal stenosis will not turn back the wheel of time and remove spinal degeneration. It`s about freeing nerves. If indicated, surgery for spinal stenosis can be combined with other techniques to address degenerative local pain.

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