Spinal stenosis is one of the most common diseases of the spine. The types of spinal stenosis are classified according to where they occur. Lumbar canal stenosis is a narrowing of the lumbar spinal canal at the bottom of the spine. In this article, learn about spinal canal stenosis and its types, symptoms and treatment in Turkey.
The stenosis of the spinal canal Spinal stenosis (It is a narrowing of the space in which the spinal cord passes through the spine) causing pressure on the spinal cord and the nerve roots that come out of each vertebra.
Symptoms caused by spinal stenosis include pain in the arms or legs/tingling, numbness and muscle weakness/low back and neck pain.
There are many treatments available for this condition that include physical therapy, medication, and surgery.
What is spinal stenosis?
Spinal stenosis is a narrowing of one or more vertebral forams in the spine that compresses the spinal cord (spinal cord) and nerves.
The most common causes of spinal stenosis are osteoporosis and degenerations that naturally affect the vertebrae with age.
Types of stenosis: Spinal canal stenosis can occur anywhere along the spine, but it most often appears in the lower back (lumbar), which is the most common, or in the cervical (cervical) spine.
The condition usually develops slowly over time, which is why many people may not experience symptoms of stenosis within the spinal canal despite the presence of changes visible on radiographs.
Depending on the location and severity of spinal stenosis, neurological symptoms vary between pain/numbness/tingling/muscular weakness in the neck and/or lower back, arms, and legs.
What are the symptoms of spinal stenosis?
Spinal stenosis is diagnosed by magnetic resonance imaging or computed tomography, and spinal stenosis may be diagnosed despite the absence of symptoms.
Although any part of the spine is affected, spinal stenosis in the lower back and neck is the most common.
Stenosis, the location of the injured, many other factors determine the appearance of symptoms.
Symptoms of spinal stenosis in the neck (cervical spine)
- Numbness or tingling in the hand, arm, foot, or leg (anywhere below the point of stenosis).
- Weakness in the hand (clumsy), arm, foot or leg
- Loss of function (asthenia) in the hands, such as having trouble writing or cuffing buttons.
- Disorders in walking and balance
- neck pain
- In severe cases, the inability to adjust the bowel and bladder.
- Some may suffer from dizziness and balance disorders
Symptoms of lumbar spinal stenosis:
- Numbness or tingling in the buttock, foot, or leg
- Feeling of weakness (weakness) in the foot or lower leg (heaviness in the legs).
- Feeling of pain or cramping and cramps in one or both legs when standing for long periods of time or when walking, and it subsides when bending forward, sitting or walking uphill.
- Low back pain: Described as bouts of mild soreness, such as an electric or burning sensation.
- Sciatica (compression of the sciatic nerve): pressure on the sciatic nerve causes pain that begins in the buttocks and extends to the lower leg and may extend to the feet.
- Loss of bladder or bowel control in severe cases.
Spinal stenosis in the thoracic spine:
- Numbness or tingling in the arm, hand, leg, or foot.
- Balance problems.
What are the causes of spinal canal stenosis?
The spine extends from the neck to the lower back.
The spinal cord is located within the spinal canal in the spine, as the job of the spine is to protect the spinal cord and nerves from any trauma or trauma.
Spinal stenosis may be congenital, but it is often acquired.
Spinal stenosis has many causes, and the common denominator among them is the change that it causes in the vertebrae, which causes narrowing of the space around the spinal cord and nerves and pressure on them.
Some reasons :
- Congenital spinal stenosis:
This is a condition in which a person is born with a small and narrow spinal canal. Some diseases of the spine may cause narrowing of the spinal canal, such asscoliosis.
- Bone overgrowth (joint spurs) :
In chronic inflammatory conditions, the articular cartilage that covers the bony surfaces of the joints is eroded.
As a result of cartilage wear, the bones begin to rub against each other, as the body responds by forming a new bone spur.
The spurs commonly occur from the vertebrae into the spinal canal and compress the spinal cord.
Paget's disease of bone can also cause overgrowth of bone in the spine, and narrowing of the nerves.
- the disk herniationHerniated disks:
Between the vertebrae are flat, round cushions (intervertebral discs) and these discs act as shock absorbers along the spine.
With age, the outer edge of these discs may rupture, and a jelly-like substance may come out of them, compressing the spinal cord (spinal cord) and narrowing the spinal canal.
- thick laces:
They are fibrous ligaments that stabilize the spine. Arthritis leads to an increase in the thickness of the ligaments and a narrowing of the spinal canal.
- Tumors of the meninges or spinal cord (spinal cord):
It is an uncommon condition diagnosed on radiographs. As it grows, it compresses the spinal cord (spinal cord) and nerve and causes narrowing of the spinal canal.
- Injuries and fractures of the vertebrae:
Trauma or accidents can cause dislocations or fractures of the vertebrae, changing their position and putting pressure on the spinal cord and nerve roots and narrowing the spinal canal.
Risk factors for spinal stenosis
- Spinal stenosis can affect anyone, but it is most common in the 50s.
- Scoliosis or vertebral fractures.
If the condition is aggravated and neglected, spinal stenosis may lead to the following:
- Numbness and muscle weakness
- balance disorder
Diagnosis of spinal stenosis
To diagnose stenosis, the doctor asks about symptoms, a detailed history and medical history, followed by a complete neurological examination.
An accurate diagnosis may require several x-rays.
Radiographic tests to diagnose spinal stenosis may include:
- X ray: X-rays show bone spurs that may be pressing on the spinal cord and nerve roots.
- Magnetic resonance imaging (MRI): MRI reveals detailed images of the spinal cord and nerve roots and diagnoses any tumor.
- Computerized tomography (CT) scan or computed tomography scan of the spinal cord A doctor may recommend a computerized tomography (CT) scan, which is a procedure that visualizes the spinal cord and nerves and may show herniated discs, bone spurs, and tumors.
Spinal stenosis treatments:
The choice of treatment for a stricture depends on the cause of the symptoms, the location of the stricture, and the severity of the signs and symptoms.
If the patient's symptoms are mild, the doctor may recommend some home remedies first.
If these treatment methods do not work and if the condition worsens, the neurologist recommends physical therapy, medications and finally surgery.
Home treatments for spinal stenosis include:
Heat is usually the best option in cases of stenosis caused by osteoporosis.
Heat increases blood flow, which relaxes muscles and relieves joint pain. Be careful when using heat - don't set settings too high as you won't burn.
If heat does not relieve symptoms, try cold compresses (ice pack, frozen gel pack, frozen pea or corn pack). Ice is usually applied for 20 minutes and 20 minutes. Ice reduces swelling and inflammation.
The exercise is useful in relieving pain, strengthening the muscles to support the spine, and improving flexibility and balance. These exercises are performed under the supervision of a specialist.
Non-surgical spinal stenosis treatments:
NSAIDs such as ibuprofen and naprexen can help reduce inflammation and relieve pain caused by spinal stenosis. Do not take these medications indiscriminately. Talk to your doctor about them. Indiscriminate use may put you at risk of developing gastric ulcers.
Pain relievers such as tricyclic antidepressants such as amitriptyline are recommended. Opioids, such as oxycodone (Oxycontin®) or hydrocodone (Vicodin®), may be prescribed for short-term pain relief. However ,described Usually with caution as it can cause addiction.Muscle relaxants can relieve muscle tension and spasms.
Spinal stenosis patient may avoid movement to relieve pain, resulting in long-term muscle atrophy and increased pain. Physical therapists will give each patient a special back exercise program to help the patient gain strength and improve balance, flexibility, stamina and spine stability. Strengthening the back and abdominal muscles will make the spine more flexible.
Physical therapists can teach you how to walk in a way that relieves spinal stenosis, which can help relieve pressure on nerves.
Injecting a corticosteroid near a narrowed spinal canal can help reduce inflammation and swelling of the surrounding nerve roots. It is not recommended to repeat these injections more than three or four times a year because corticosteroids may cause damage.
Also known as image-guided lumbar decompression (PILD), this procedure specifically treats stenosis of the lumbar spinal canal caused by thickening of the ligaments (ligamentum flavum) in the back of the spine. Being Through a small incision and does not require general anesthesia or stitches.yGuided X-ray procedure The surgeon uses special tools to remove part of the overgrown ligament and widen the narrowed spinal canal, expanding the space within the spinal canal and reducing pressure on the nerve roots.
The advantages of this procedure are that the bone structure of the spine is left intact and it is a minimally invasive procedure after which patients recover quickly. Patients usually return home a few hours after the procedure and begin walking and/or physical therapy shortly thereafter. Compared to before the procedure, you will be able to walk and stand for longer periods of time and the numbness or tingling sensation and muscle weakness will ease.
We resort to surgery when all other treatment options have failed. Fortunately, most people with spinal stenosis do not need surgery. However, your doctor may recommend surgery if your signs and symptoms are very severe and affect daily life, difficulties with balance and walking due to pressure on the spinal cord and nerves. The goal of the surgery is to relieve spinal canal stenosis and free the nerves.
Surgery options include removing portions of the vertebrae and formed bulges or discs that narrow the spinal canal and put pressure on the spinal cord (spinal cord). Spinal stenosis surgeries include:
The most common type of spinal stenosis surgery, the operation involves removing the lamina which is the back part of the vertebra, and the bony spurs and surrounding tissues can be removed, which relieves the narrowing of the spinal canal, and makes room for the spinal cord and nerves. Doctors may need to connect the vertebra with adjacent vertebrae with bone grafts or metal devices.
Laminotomy (partial laminotomy):
In a laminotomy, only parts of the lamina that press on the spinal cord are removed.
Laminoplasty (to treat Spinal stenosis cervical ):
Laminoplasty is performed to treat narrowing in the neck only. Dilatation of the spinal canal through laminectomy for several consecutive vertebrae and the use of metal plates and screws as an articulating bridge across the vertebrae.
The foramen is the space inside the vertebrae where nerve roots exit. Vertebral puncture involves removing spurs of bone and tissue to free up space and relieve pressure on the spinal cord (spinal cord) and nerves.
Minimally invasive surgery for spinal stenosis:
Protrusions or plates are removed in a conservative manner that minimizes damage to nearby healthy structures and tissues the operation under local anaesthesia. It is considered one of the most important types of stenosis surgery for those who suffer from chronic diseases and cannot tolerate general anesthesia.
It is considered one of the complex operations, based on the principle of merging (linking) two consecutive paragraphs permanently together. A laminectomy is usually performedBeing Laminectomy first andCompleteBones are removed during this procedure to create a bridge between two vertebrae.
bounceThe vertebrae are attached with screws or wires until they heal and grow together. The healing process takes six months to one year. Helps stabilize the spine and relieve pain.
What are the risks of spinal stenosis surgery?
Undergoing surgery involves many risks, such as infection, bleeding, blood clot formation, and a reaction to anesthesia. Some complications arising from spinal stenosis surgery:
- Nerve injury.
- A tear in the meninges (the membrane covering the spinal cord).
- The bone failed to heal after surgery.
- Failure of sheet metal, nails and other fasteners.
- The need for additional surgery.
- Relapse of symptoms.
What is the recovery period after? surgery Spinal stenosis?
Full recovery after surgery for spinal stenosis and return to normal activities usually takes three months and possibly longer for spinal fusion, depending in part on the complexity of the surgery and the progress of rehabilitation.
If you've had a laminectomy, you'll likely be able to return to a desk job within a few days of returning home.
If you've had spinal fusion surgery, you'll likely be able to return to work a few weeks after surgery.
Can spinal stenosis be prevented?
Spinal stenosis is not 100% preventable. However, you can take some measures to reduce the risk or slow down the progression, including: maintaining an ideal body weight, avoiding smoking, adhering to the exercises prescribed by a physical therapist is an important condition to relieve pressure on the spine.
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