Spinal stenosis is a term used to refer to a narrowing of the spinal canal.
When the narrowing occurs in the town of the spinal canal it may press upon the spinal cord. If thenarrowingoccurs on the side of the spinal canal it may press upon the nerves - this may corollary in either what are termed lateral recess stenosis or foraminal stenosis depending on either the stenosis is in the lateral aspect of the spinal canal or in the neuroforamen where the nerve exits. Both of these sub-types of spinal stenosis may affect the nerve in the region.
Spinal stenosis is one of the most common causes of back pain for Americans. In fact, almost 70% of people with spinal stenosis have back pain. This may range from intermittent discomfort to severe and disabling spinal arthritis pain.
Many of those suffering with spinal stenosis perceive what is termed, neurogenic claudication. This results in pain or weakness in the legs as a someone attempts to walk a long distance. Eventually, the distance a personis able towalk is severely limited. As a result, these people may be disabled.
One of the common signs of neurogenic claudication is called the "grocery cart sign", i.e., when a someone with important neurogenic claudication walks a distance, they begin to feel the symptoms into their legs. When this occurs they may simply sit down for a few minutes and the symptoms may resolve. However, many people will simply bend send and lean on the cart to gain relief. The corollary of leaning send on the cart opens the spinal canal and provides more room for the spinal cord or nerves. Even a small estimate of further room can have a important impact on the distance/duration these people can walk.
There are many causes of spinal stenosis but the most common cause is uncomplicated aging. As we age, our spine degenerates and a condition known as spondylosis develops. Spondylosis is the healing term for spinal degeneration or arthritis.
Spondylosis may occur in the lower back and is termed, lumbar spondylosis. It may also occur in the neck and is termed, cervical Spondylosis.
When cervical spondylosispresses upon the spinal cord, it is termed cervical spondylotic myelopathy (Csm); when the cervical spondylosis affects a nerve to the upper extremity, it is referred to as cervical spondylotic radiculopathy (Csr); and, when both the spinal cord and a nerve are associated with cervical spondylosis, it is referred to as cervical spondylotic myeloradiculopathy (Csmr).
Unfortunately, there is no cure for spinal stenosis and it is a progressive disorder. However, there are many treatments available that furnish relief along with corporal therapy, chiropractic, pain injections and surgery.
Regardless of the medicine selected, it is foremost for those with spinal stenosis to stay active and practice to enounce strong core muscles which retain the spine.
For those who do not sass to conservative treatment, surgery may be required. The goal of surgery is to resolve the neurogenic claudication and the back pain. Typically, a uncomplicated decompression of the spinal stenosis will comfort the back pain and the neurogenic claudication. A spinal fusion is rarely necessary.
One of the most developed and well-tolerated treatments of spinal stenosis uses minimally invasive spine surgery techniques. Using small camerascalled endoscopes, specially trained spine surgeons can remove the spinal stenosis using only very small incisions. Many innovative surgeons also use laser spine surgery techniques as well because the laser has the unique capability to vaporize areas of stenosis that would otherwise want more tissue removal to resolve.
Minimally invasive spine surgery is typically performed on an out-patient basis with no hospitalization required. It is performed using the small endoscopes or very small tubular retractors. Each of these techniques has their own indications but the corollary is resolution of the spinal stenosis straight through very small incisions designed to protect the overlying muscles of the spine. This minimizes any scarring and there is virtually no blood loss.
These types of surgical procedures do not want normal anesthesia so patients with heart conditions who may not otherwise be able to tolerate a spinal course are not excluded.
Laser spine surgery offers the further benefits of ablating the nerves to the small joints that may be an further source of back pain. The lasercan also safely decompress painful discs.
All of these techniques are performed in a singular setting so that all the sources of pain are addressed in one procedure.
Today, some innovative minimally invasive spine surgeons are also using adult stem cells derived from the patient's own bone to further minimize any scar formation. These adult stem cells, not embryonic stem cells, play an foremost role in down-regulating inflammation and reducing pain.
Left untreated, spinal stenosis can severely affect the capability to walk.
However, today's developed minimally invasive spine procedures can typically resolve the spinal stenosis and forestall progression during a uncomplicated out-patient course without the need for normal anesthesia or spinal fusion.
Additional articles by author:
Thoracic Surgery:Spinal Stenosis - Minimally Invasive Spine surgical operation Relieves Stenosis Without Need for Spinal Fusion
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