What is Spinal Stenosis?
Spinal stenosis is the condition which causes the abnormal narrowing (stenosis) of the space within the spinal canal. This restriction of the spinal canal puts undue pressure on the vital motor nerves that originate from the spinal cord and are responsible for control of the limbs.
Spinal stenosis is mostly seen in the lower (lumbar) region of the back. Osteoarthritis is often the main cause for the development of spinal stenosis.
What are the causes for Spinal Stenosis?
There are a number of causes that are suspected to be responsible for the development of spinal stenosis, such as:
Aging – Advancing age causes the ligaments in the body to thicken. Bone spurs (abnormal growth) can be seen in the bones including the vertebrae. This also causes the supporting inter-vertebral disc to begin deteriorating with time. The facets (flat surface) of the vertebra are responsible for keeping the movement of the spine normal. These are also responsible to keep the spine in a healthy shape and these facets are also known to get misshapen with age. All these factors are related to aging in a person and can cause spinal stenosis.
Arthritis - Osteoarthritis and rheumatoid arthritis affect the vertebrae as well as the other major weight-bearing joints such as knees and hip. Arthritis affecting the spinal column can give rise to spinal stenosis.
Spondylolisthesis – If any of the vertebra or the inter-vertebral discs slip away from their normal aligned position in the spinal column it can lead to spinal stenosis by narrowing the spinal canal.
Spinal tumors - An uncontrolled (cancerous) tissue growth near, or on, the spinal canal can adversely affect its size. This tumor tissue also increases the risk of bone re-sorption, which causes bone deterioration due to overactive bone cells, and even displacement of the bone which might be risky for the stability of the spinal column.
Trauma – Injury/trauma to the back can cause dislocation/fracture of the vertebras. This may cause the broken pieces of bone to put undue pressure on the spinal cord and surrounding nerves, resulting in spinal stenosis.
What are the signs and symptoms of Spinal Stenosis?
There are various physical and neural signs and symptoms seen after the development of spinal stenosis:
- Difficulty standing
- Pain in hand/arm/shoulder
- Numbness/tingling sensation in lower body
- Weakness in limbs and back
- Loss of bladder/bowel control in severe cases
- Difficulty in walking
- Loss of reflex (especially in the arms)
How is Spinal Stenosis diagnosed?
The doctor will need to check your medical history to look for any other underlying condition that may induce similar symptoms. A thorough physical examination is followed after this.
The doctor might need to perform certain imaging tests on the spine to determine the location and extent of the stenosis as well as the cause for narrowing of the spinal canal.
X-ray – This test helps to create a clear image of the spine and the its components which helps to check for damage to the various parts of the spinal column.
Magnetic resonance imaging (MRI) – This test creates a better image of the softer tissues such as nerves, spinal cord, discs and muscles for observation for abnormalities or damage.
Computerized Tomography (CT) Scan – The doctor may order additional tests such as a computerized tomography (CT) scan to see the vertebral bone structure more closely. A ‘myelogram’ is also performed to see for abnormalities in the nervous structure around the spine. A myelogram uses a special dye injected into the spine to highlight the nerves.
How is Spinal Stenosis treated?
There are various types of treatments available for spinal stenosis. The exact type of treatment for any particular case will largely depend on various factors such as age, overall physical health, extent and location of the stenosis along with your preference and the doctor’s/surgeon’s advice.
Non-surgical treatments for spinal stenosis are aimed at alleviating pain and restoring function to the spine. Although non-surgical treatments are not effective in treating the narrowing of the spine they are however found to be successful in relieving the other painful symptoms.
Physical therapy – Exercises for stretching, massage and other back strengthening are helpful in relieving the pain.
Lumbar traction – Lumbar traction has been found to be effective in many cases to relieve pain.
Anti-inflammatory drugs – As stenosis of the spinal canal causes painful symptoms it helps to relieve these through decreasing the inflammation around the spinal canal. Non-steroidal anti-inflammatory drugs (NSAIDs) are found to provide pain relief in the initial stages of the disorder.
Steroid injections – Steroid injections require administering cortisone, a powerful anti-inflammatory drug, directly in the space around the nerves. These cortisone injections are helpful in reducing the swelling as well as in alleviating the pain. Cortisone injections also decrease numbness in the limbs.
The surgical treatment of spinal stenosis is advised for patients who are severely affected due to intense pain and excess weakness in the back and limbs.
These are the surgical treatment options for treatment of spinal stenosis:
Laminectomy - This procedure requires removing the rear part (lamina) from the damaged vertebra. This helps increase the space in the spinal canal and relieves the pressure from the spinal cord and surrounding nerves.
Laminotomy - This surgery requires removing only a part of the lamina (usually by making a small hole in the back of the affected vertebra) to relieve the pressure from the spinal cord.
Laminoplasty - This surgical procedure is typically used for treating stenosis in the neck (cervical) vertebrae. This surgery involves scoring the lamina from one side till it becomes thinner and then proceeding to cut the same lamina from the other side to create a ‘hinged door’ system. This lamina is opened to release the pressure from the spinal cord. The surgeon uses surgical-grade metal rods, plates and screws to hold the scored lamina in the modified position permanently.
Spinal fusion - This surgery requires making a gap between the damaged parts of the vertebra to relieve the pressure from the narrowed spinal canal. The next step involves injecting a ‘bone cement’ (bone adhesive material) to seal the gaps as well as to provide support to the weak vertebra till it gets healed and strengthens naturally.
Why choose Travcure for Spinal Stenosis Surgery in India?
India is home to the largest and most comprehensive healthcare network. It is spread across all major cities such as Delhi, Mumbai, Chennai, etc which is most convenient for patients flying in from abroad to India for medical treatments. Travcure has been working with this large network of multi-specialty global-class hospitals to provide excellent and effective spinal stenosis treatment for every patient at the most affordable cost.