Spinal stenosis surgery or spinal canal in Turkey which is done using electron microscope For the treatment of compression caused by a bony or cartilaginous spur on the vertebral canal.
Spinal stenosis is a common condition that occurs when the small spinal canal, which contains nerve roots and the spinal cord, compresses the spinal cord and/or nerve roots, causing pain, cramping, weakness or numbness. Depending on where the stenosis occurs, you may feel these symptoms in your lower back, legs, neck, shoulder or arms.
Usually stenosis is caused by osteoarthritis, or arthritis, of the spine and the discs between the vertebrae (back bones).
It may also be due to thickening of the ligaments in the back, as well as bulging discs that separate the vertebrae.
Symptoms of spinal stenosis often start slowly and get worse over time.
The pain in the legs may become so severe that it is difficult to walk even for short distances.
Often, sufferers need to sit for temporary pain relief.
What is spinal stenosis?
Spinal stenosis is the narrowing of one or more areas of the spine.
This narrowing, which often occurs in the lower back or neck, can compress the spinal cord or nerves that branch off from compressed areas.
A person with this condition usually complains of severe pain in the legs, calves, or lower back when standing or walking. The pain may come on more quickly when walking up or down a hill, incline, or stairs. The pain is usually relieved by sitting or bending.
What causes spinal stenosis and who does it affect?
Some people are born with a small spinal canal. This is called "congenital stenosis".
However, spinal stenosis is often due to age-related changes that occur over time. This is called "acquired spinal stenosis".
The risk of developing spinal stenosis increases in the following cases:
- In those born with a narrow spinal canal.
- in females.
- After reaching the age of 50 years.
- In those who have had a previous injury or have undergone spinal surgery.
Some medical conditions can also cause spinal stenosis. Which:
- Osteoporosis and bone spurs (beaks) that form as we age.
- Rheumatoid spondylitis (eg, ankylosing spondylitis).
- Spinal tumors.
- Paget's disease: It is a chronic disease that affects the elderly and is represented by damage to bone tissue, especially in the spine, skull or pelvis
How is spinal stenosis diagnosed in Turkey?
Your doctor will ask about your symptoms and your medical history.
If he suspects spinal stenosis, he or she will perform an examination of your body. Some of the symptoms he will look for include:
- Numbness, weakness, cramping, or pain in the legs, thighs, or feet that makes it difficult for you to walk.
- Pain extending down the leg.
- Impairment of bowel and/or bladder function.
- Loss of sexual function.
In severe cases, partial or complete paralysis of the leg. This is considered a medical emergency and you should get to the emergency room as soon as possible.
A rheumatologist will also consider other conditions that can cause similar symptoms, such as arthritis in the hips or knees; disorders of the nervous system;
or cardiovascular disorders. Your rheumatologist may also order other tests to confirm the diagnosis and determine the severity of your condition. These include:
- X-ray of the spine to check for osteoporosis, bone spurs (beaks), and spinal stenosis.
- Computed tomography (CT SCAN) scan, which takes more detailed pictures of the back and spinal canal.
- Magnetic resonance imaging (MRI SCAN) of the spine to take pictures of the spinal cord and nerves.
- An electromyogram (EMG) to check the nerves going into your legs.
- X-rays of your hips or knees, blood tests, as well as tests to check the circulation in your legs and rule out other diseases with similar symptoms.
How is spinal stenosis treated in Turkey?
Although there is no definitive cure for spinal stenosis, regular exercise, medication and, in some cases, surgery can provide relief.
Regular exercise can help you build and maintain strength in the muscles in your arms and upper legs (hip flexors and extensors, quadriceps and hamstrings).
This will improve your balance, ability to walk, bend and move, and control pain.
A physical therapist can show you which exercises are right for you.
Over-the-counter medications such as acetaminophen (Tylenol), or nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Anaprox), may also relieve pain.
In addition, the doctor may prescribe other medications to help with pain and/or muscle spasm.
Cortisone injections (corticosteroid injections):
An injection directly into the area around the spinal cord (known as an epidural injection) may provide a great deal of temporary and occasional relief.
However, there is little objective data to support the use of cortisone injections to treat spinal stenosis.
These injections are usually given on an outpatient basis in a hospital or clinic.
Spinal stenosis surgery in Turkey
Spinal decompression and spinal fusion
Do you need surgery to treat spinal stenosis?
Most patients with cervical or lumbar spinal stenosis respond well to nonsurgical treatments (such as medications), so you may not need spinal surgery.
However, there are situations that may require going forward with spine surgery:
- Failure to respond to non-surgical treatments.
- Severe pain for a long period of time.
- Radiculopathy, a medical term used to describe pain, numbness and tingling in the arms or legs.
- Loss of sensation in the arms or legs.
- Decreased motor power in the arms or legs.
- Loss of bowel or bladder control (cauda equina syndrome, for example).
One of the main goals of surgery for spinal stenosis in the neck or lower back is to free the region of the spinal cord and/or nerve roots. This is called decompression.
By giving the spinal cord and nerve roots more space to pass through, a spine surgeon hopes to reduce pain from nerve inflammation.
Another goal of spinal stenosis surgery is to increase the motor strength in the arms or legs. If you lose sensation in your arms or legs, your surgeon also hopes to restore it.
Types of Spinal Stenosis Surgery
Surgeons usually use two surgical techniques for spinal stenosis surgery:
- Remove or relieve stress: The surgeon removes tissue that is pressing on the nerve structure, freeing up more space in the spinal canal (for the spinal cord) or in the foramen (for nerve roots).
- Installation: The surgeon works to limit movement between the vertebrae.
First: decompression surgery to treat spinal stenosis
To remove tissue pressing on a nerve, a spine surgeon may perform one of the following types of surgery:
If part of a disc or a bony spur (a bone spur) is pressing on a nerve as it exits a vertebra (through an outlet called the intervertebral foramen), a foraminotomy may be performed. It means "open a window".
So the incision of the foramen makes the opening of the foramen larger, so that the nerve can exit without being compressed.
Similar to a laminotomy, the laminotomy creates a larger opening in the lamina, this time, as the lamina may compress the nerve, so the surgeon may make more room for the nerves when using a laminotomy.
Which is very similar to Disc surgery with a microscopeIn some cases, laminotomy may not be sufficient.
The surgeon may need to remove all or part of the lamina, a procedure called a laminectomy.
This can often be done on many levels without any adverse effects.
Indirect decompression is a form of decompression surgery in which decompression is relieved by separating the bones instead of removing the bones with artificial discs.
This can be done using devices that are placed between the vertebrae.
Artificial discs can also relieve pressure by restoring height between adjacent vertebrae.
Second: stabilization surgery to treat spinal stenosis
Not everyone who will have spinal stenosis surgery requires immobilization, also known as spinal fusion.
It is particularly useful in cases where one or more vertebrae slip out of the correct position, making the spine unstable (and painful).
In these cases, the sliding bone can put pressure on the nerves.
The need for fixation also depends on how many vertebrae the surgeon needs to operate on.
For example, if the lamina needs to be removed (using a laminectomy) in multiple vertebrae, the spine may be unstable without these structures.
A fusion of the spine will be needed to help stabilize it.
Spinal fixation surgery has been popular for many years.
It can be performed alone or at the same time as decompression surgery.
In spinal stabilization, the surgeon creates an environment in which the bones of the spine fuse together over time (usually over the course of several months or longer).
The surgeon uses a bone graft (usually using bone from your own body) or a biomaterial (which stimulates bone growth).
The surgeon may use spinal tools (wires, cables, screws, rods, and plates) to increase stability and help fuse the bones.
. The fusion will stop movement between the vertebrae, providing long-term stability.
Open spine surgery or minimally invasive spine surgery?
If the surgery is done through a relatively large incision in your back, this is called open surgery. Another option is Minimally invasive surgery, which is made through several small incisions. The surgeon may use a microscope, an endoscope, a tiny camera, and very small surgical tools.
However, minimally invasive surgery is not appropriate for everyone. If your surgeon needs to operate on many vertebrae, you may need to perform open surgery.
The patient should be aware of the surgical risks
As with any surgery, there are risks associated with spinal stenosis surgery. Your doctor will discuss the potential risks with you before asking you to sign a surgical consent form. Possible complications include, but are not limited to:
- General risks of anesthesia
- Injury to the spinal cord or nerves
- Bone fusion not healed (pseudoarthrosis)
- Fail to improve.
- Fracture/failure of instruments placed by the surgeon (screws, plates, rods, wires)
- Infection and/or pain at the bone graft site
Recovery from spinal stenosis surgery
After surgery, you won't get better right away. You'll likely get out of bed within 24 hours, and you'll take pain relievers for 2 to 4 weeks. After surgery, you'll receive instructions on how to sit, stand, and stand carefully.
It's important to give your body time to recover, so your doctor will likely recommend restricting your activities.
In general, don't do anything that moves your spine a lot.
You should avoid contact sports, twisting or lifting weights during your recovery.
After surgery, be vigilant. Report any problems — such as fever, increased pain, or infection — to your doctor immediately.
You should always take care of your body and practice healthy habits, but you should be in good health especially after surgery. So you must:
- Follow your doctor's treatment plan.
- Sit and stand properly.
- Learn to lift things properly.
- Exercising regularly (especially light exercise is good, but check with your doctor first).
- Use appropriate sports equipment.
- Reach and maintain a healthy weight.
- Eat healthy foods (a balanced, low-fat diet rich in fruits and vegetables) and get enough calcium.
- stop smoking.
- Avoid excessive use of alcoholic beverages.
The results of surgery to correct spinal stenosis are usually good. In general, 80% to 90% patients recover from their postoperative pain.