What is Spinal Stenosis?
Spinal stenosis is the abnormal narrowing (stenosis) of the space within the spinal canal. This contraction of the space in the spinal column puts undue pressure on the important motor nerves that originate from the spinal cord and are responsible for control of your arms and legs.
Spinal stenosis is mostly seen in the lower (lumbar) region of the back (spinal column). Osteoarthritis is often the main cause for the development of spinal stenosis in a person.
What are the causes for Spinal Stenosis?
There are a number of suspected causes that are responsible for the development of spinal stenosis in a person, such as:
As time passes the ligaments in your body can become thicker. Abnormal growths (spurs) can be seen in the bones including the vertebra around the spinal cord. It also causes the supportive vertebral disc to begin deteriorating with extensive use. The flat surface of the vertebra (facets) are responsible for keeping the movement of the spine normal as well as keeping it in a healthy shape and these facets are also known to get weakened with age. All these factors are related to aging in a person and can cause narrowing of the spinal canal (stenosis).
Osteoarthritis and rheumatoid arthritis are known to affect the spinal joints along with the other weight-bearing joints in the body such as knees and hip joints. Any type of arthritis affecting the spinal column can give rise to spinal stenosis in a person.
In case any of the vertebra or the vertebral discs slip away from their naturally aligned position in the spinal column it can lead to spinal stenosis by narrowing the spinal canal.
An uncontrolled tissue growth near, or on, the spinal canal can adversely affect its size. This tumor tissue also increases the risk of bone resorption (bone deterioration due to overactive bone cells) and even displacement of the bone which might be risky for the stability of the spinal column.
An injury or trauma to the back can result in the dislocation as well as fracture of any of the vertebras that may cause the broken pieces of bone to put undue pressure on the spinal cord and surrounding nerves.
What are the symptoms of Spinal Stenosis?
There are various signs and symptoms that are seen either as physical or neural in nature, such as:
- Difficult to stand
- Pain in the hand, arm and shoulder
- Numbness/tingling sensation in the lower body
- Weakness in the limbs and the back
- Loss of bladder and even bowel control in severe cases
- Difficulty in walking
- Loss of reflex in the arms especially
How to diagnose Spinal Stenosis?
Spinal stenosis is diagnosed by observing the visible physical symptoms. 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 your back to determine the location and extent of the stenosis as well as the cause for the spinal canal narrowing.
X-ray – An x-ray test can help the doctor by looking at the bone structure of your spinal column (vertebras and discs) to look for the causes of a stenosis such as aging signs, bone spurs and loss of disc height.
Magnetic resonance imaging (MRI) – This diagnostic test lets the doctor get a better view of the softer tissues such as nerves, spinal cord, discs and muscles.
Other tests – 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 nerves. A myelogram uses a special dye injected into the spine to highlight the nerves.
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What are the treatment options for Spinal Stenosis?
There are various types of treatment options available to treat spinal stenosis. The type of treatment best suited for you will 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 options for spinal stenosis are aimed at relieving pain and restoring function to the compressed spinal cord. Although non-surgical treatments are not much effective in treating narrowing of the spine but they are found to be successful in relieving painful symptoms.
Physical therapy – Exercises for stretching, massage and other lumbar and abdominal strengthening are found to be helpful in relieving painful symptoms.
Lumbar traction – Lumbar traction has been found to be adequately affective in certain patients.
Anti-inflammatory drugs – As stenosis (narrowing) of the spinal canal causes painful symptoms to develop therefore it helps to relieve these painful symptoms through decreasing the swelling (inflammation) around the spinal canal. Non-steroidal anti-inflammatory drugs (NSAIDs) are found to provide pain relief in the initial stages.
Steroid injections – Steroid injections involve the administering of cortisone, a powerful anti-inflammatory drug, in the epidural space around the nerves directly. These cortisone injections are helpful in reducing the swelling as well as alleviate the pain. Cortisone injections also decrease numbness in the limbs.
Acupuncture – Mild to moderate cases of stenosis are advised an acupuncture session to help decrease pain.
Chiropractic manipulation – Mild lumbar stenosis cases benefit from chiropractic manipulation as the pain is significantly reduced. This option is not advisable for patients with herniated disk or osteoporosis as it can worsen the condition.
The surgical options for treatment of spinal stenosis are generally advised for patients who are severely affected by it due to pain and weakness in the back and limbs.
These are the surgical treatment options for treatment of spinal stenosis:
This procedure involves the removal of the lamina (posterior part) of the damaged vertebra. This helps increasing the space in the spinal canal and relieving the pressure from the spinal cord and surrounding nerves.
This surgical procedure requires the surgeon to remove 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.
This is the typical surgical procedure for stenosis in the cervical (neck) vertebras. This procedure involves scoring the lamina (back portion of the vertebra) from one side till it becomes thinner and then cutting the same lamina from the other side to create a ‘hinged door’-like system. This lamina is then 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 surgical procedure involves the surgeon making a gap between the damaged (broken) parts of the vertebra to relieve the pressure from the narrowed spinal canal, and injecting a ‘bone cement’ (bone adhesive material) to seal the gaps as well as to provide support to the initially weak vertebra bone till it gets healed and strengthens naturally.
Why India is best for Spine Surgery?
The orthopedic specialty hospitals and clinics in India are a part of a larger network that is present in all major Indian cities such as New Delhi, Mumbai, Chennai, Kolkata, Pune, Bangalore, Hyderabad, etc. These specialty clinics and hospitals are fully-equipped with the latest and most modern surgical instruments and devices that help the extremely experienced orthopedic surgeons and doctors to perform spine treatment surgeries in the most efficient manner. The added advantage of getting spine surgical treatment in India is the availability of world-class treatment at the lowest cost and a budget-friendly price.