Spinal stenosis
Spinal stenosis in nagpur is a condition of narrowing of cervical spinal stenosis that places pressure on the spinal cord as well as the nerves tissue. It can be in either of the following sites:
1. Lumbar spine (lower back)
2. Neck/Cervical spine
3. Middle back or thoracic spine
The most common cause of spinal stenosis is the damage that occurs to an object in ordinary harm and injury in the spine related to arthritis. People who have serious spinal stenosis may require surgery.
Causes:
1. Aging and wear and tear
2. Osteoarthritis
3. Herniated discs
4. Bone spurs
5. Spinal injuries
6. Tumors
7. Congenital conditions
Spinal stenosis can be classified into three types:
1. Central stenosis or narrowing of the central spinal canal
2. Lateral stenosis or narrowing of the lateral spinal canal
3. Foraminal stenosis or narrowing of the neural foramen
What Is a Spinal stenosis?
Spinal stenosis is the narrowing of the inner space within the spinal cord. It can be caused by pressure on the spinal cord and on the nerves running through the spine. The lower back and the neck are most common places where spinal stenosis occurs.
Symptoms
1. Backache
2. Neckache
3. Leg pain
4. Arm pain
5. Limb weakness
Treatment
1. Pain management with medication
2. Physical therapy
3. Chiropractic care
4. Exercise
5. Surgery (decompression, laminectomy, fusion)
There are four subtypes of spinal stenosis, classified as follows:
1. Central stenosis, which is the narrowing of the central spinal canal.
2. Lateral stenosis, that is the narrowing of the lateral spinal canal
3. Foraminal stenosis, that is the narrowing of the neural foramen.
What Is a Spinal stenosis?
- Cervical spinal stenosis: It occurs at the neck segment, where it compresses the spinal cord or even the nerve roots.
- Lumbar Spinal Stenosis: This is a condition that occurs at the lower back and is also the most common form of spinal stenosis where it compresses the nerves that travel into the legs.
- Thoracic Spinal Stenosis: A less common type that affects the upper to middle part of the back.
Causes of Spinal Stenosis:
- Aging: The most common cause is the natural aging process, which can lead to degenerative changes in the spine, such as:
- Osteoarthritis: The breakdown of cartilage between joints can cause bone spurs, which narrow the spinal canal.
- Herniated Discs: The soft, gel-like center of a spinal disc can bulge or rupture, pressing on the spinal cord or nerves.
- Ligament Thickening: Ligaments that hold the spine together may thicken and stiffen, reducing the space for nerves.
- Bone Spurs: Bony overgrowths can form as the body compensates for degenerative changes, narrowing the spinal canal.
- Congenital Spinal Stenosis: Some people are born with a naturally narrower spinal canal, making them more susceptible to the developing symptoms later in life.
- Spinal Injuries: Traumatic injuries can cause dislocations, fractures, or swelling that lead to narrowing of the spinal canal.
- Tumors: Spinal tumors can grow and compress the spinal cord or nerves, leading to stenosis.
- Paget’s Disease: A bone disorder that can cause abnormal bone growth, leading to narrowing of the spinal canal.
Symptoms of Spinal Stenosis:
- Back or neck pain: This is often the first symptom and can vary in intensity.
- Numbness or tingling: Especially in the arms, hands, legs, or feet, due to nerve compression.
- Weakness: Muscle weakness in the arms or legs, depending on where the stenosis is located.
- Radiculopathy: Pain that radiates along the path of a compressed nerve, such as sciatica in lumbar stenosis (pain that shoots down the leg).
- Balance problems: Difficulty walking or maintaining balance due to nerve compression.
- Bladder or bowel dysfunction: In severe cases of lumbar stenosis, nerve compression can affect bladder or bowel control, which requires immediate medical attention.
Symptoms by Location:
- Cervical Spinal Stenosis:
- Numbness, tingling, or weakness in the arms, hands, legs, and feet.
- Neck pain.
- Difficulty with coordination and walking.
- In severe cases, myelopathy (compression of the spinal cord) can occur, which can lead to more severe neurological symptoms.
- Lumbar Spinal Stenosis:
- Pain and cramping in the lower back, buttocks, and legs, especially when standing or walking (this is known as neurogenic claudication).
- Symptoms improve with sitting or bending forward (as this relieves pressure on the nerves).
- Numbness and weakness in the legs and feet.
- In severe cases, difficulty controlling bladder or bowel function.
Diagnosis of Spinal Stenosis:
Diagnosis usually involves a combination of a following:
- Medical history and physical examination: The doctor will assess symptoms, such as pain patterns and neurological function, and look for signs of nerve compression.
- Imaging Tests:
– X-rays: Can reveal narrowing of the spinal canal or the presence of bone spurs or degenerative changes.
– MRI (Magnetic Resonance Imaging): The most common imaging test to assess soft tissues, such as discs, ligaments, and the spinal cord, to detect nerve compression.
– CT Scan: Provides detailed images of the bones or can show narrowing of the spinal canal.
– Myelogram: An X-ray or CT scan taken after injecting dye into the spinal canal, which highlights areas of nerve compression.
Treatment Options for Spinal Stenosis:
Treatment depends on the severity of symptoms and the extent of nerve compression. Many people with mild stenosis can manage their symptoms with conservative (non-surgical) treatments.
Non-Surgical Treatments:
- Physical Therapy:
- Strengthening exercises for the core and lower back muscles can help support the spine and improve posture.
- Stretching or flexibility exercises can reduce stiffness and improve range of motion.
- Aerobic exercise: Low-impact activities like walking, swimming, or cycling can help maintain spinal health.
- Medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen and naproxen reduce inflammation and pain.
- Muscle relaxants: To relieve muscle spasms that may accompany spinal stenosis.
- Opioids: For short-term use in cases of severe pain.
- Corticosteroid injections: Steroid injections around the affected nerves or spinal canal (epidural injections) can reduce inflammation and provide temporary relief.
- Activity Modification:
- Avoid activities that worsen symptoms, such as prolonged standing or walking.
- Use a walker and cane to help relieve pressure on the spine.
- Heat and Ice Therapy:
- Ice packs can help reduce inflammation, while heat therapy relaxes muscles and improves blood flow to the affected area.
- Chiropractic Care:
- Spinal manipulation may provide relief in some cases, though it’s important to ensure that this treatment is safe for your specific condition.
- Acupuncture:
- Some individuals find symptom relief through acupuncture, which involves inserting fine needles into the specific points in the body.
Surgical Treatment:
Surgery may be recommended if conservative treatments fail to relieve symptoms or if the stenosis causes significant disability or nerve damage.
- Laminectomy:
- The most common surgery for spinal stenosis, also known as decompression surgery.
- Involves removing the lamina (the back part of the vertebra) to create more space for the spinal cord or nerves.
- Foraminotomy:
- A procedure to enlarge the foramina (the openings where spinal nerves exit the spine) to relieve nerve compression.
- Spinal Fusion:
- May be performed alongside decompression surgery to stabilize the spine if there is instability.
- Involves fusing two or more vertebrae together with bone grafts, rods, or screws to prevent motion in the affected segment.
- Interspinous Process Spacers:
- These devices are implanted between vertebrae to maintain space in the spinal canal or reduce pressure on the nerves.
- Minimally Invasive Spine Surgery:
- Minimally invasive techniques, such as endoscopic laminectomy, can reduce muscle damage and allow for quicker recovery.
What procedures Spinal stenosis?
Spinal stenosis treatments include:
1. Conservative treatment:
Pain management through medication
Physiotherapy
Exercise
2. Intervention procedures:
Epidural injections (steroid injection or pain reliever)
Facet joint injection
Radiofrequency ablation
3. Surgical procedures:
Decompression surgery involving the removal of bone or tissue that compresses the nerves
Laminectomy
Part of the vertebra is eliminated
Fusion surgery
Two or more of a vertebrae are fused
4. Minimally invasive procedures
Endoscopic spine surgery
Tubular retraction surgery
Laser spine surgery
5. Alternative procedures
Acupuncture
Massage therapy
Yoga and physical therapy
This kind of procedure will depend on the level and location of the spinal stenosis, among other factors and the patient’s health condition. This will have to be consulted with a professional because deciding which kind of treatment would be best is quite necessary.
Some of the most common types of surgical procedures on spinal stenosis are the following:
- Laminectomy
- Fusion surgery
- Decompression surgery
- Foraminotomy
- Lateral interbody fusion
These procedures are aimed at cushioning pressure on the spinal cord and nerves, stabilizing the spine, and allowing as much mobility with minimal pain.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.