Stenosis means the choking or narrowing of a body channel and is often the result of degenerative conditions. Spinal Stenosis means narrowing of the bone channel occupied by the spinal nerves of the spinal cord. When the spinal nerves in the lower back are choked, lumbar stenosis occurs. Some people are born with a congenital form but most develop spinal stenosis as part of the denegenerative cascade.
Similarly cervical stenosis is the slowly progressive condition that pinches the spinal cord in the neck. Lumbar stenosis is very common problem these days.
Spinal stenosis may result in low back pain as well as pain in the legs.
Stenosis may pinch the nerves that control muscle power and sensation in the legs. Additional symptoms may include:
- Frequent falling or clumsiness
- Pain and difficulty when walking
- Numbness, tingling hot or cold feeling in the legs
- People with spinal stenosis may or may not have back pain depending on the degree of arthritis that has developed
CAUSES OF SPINAL STENOSIS:
- Aging- With age the body ligaments can thicken which might lead to cause the spaces in the spine to narrow.
- Arthritis- Two forms of arthritis may affect the spine- Osteoarthritis and rheumatoid arthritis
- Heredity- instability of spine or spondylolisthesis
- Tumours of the spine
- Trauma- Accidents and injuries which may dislocate the spine and the spinal cord
A few do not feel any effects of the narrowing but as part of the aging process most people will eventually notice radiating pain, weakness and/or numbness secondary to the compression of the nerves or spinal cord.
While narrowing may occur at different parts of the spine the symptoms of nerve compression are often similar. That is why specialists often will perform testing to determine the cause and location of the narrowing. While Most patients respond well to non surgical spinal stenosis treatment such as medication who don’t have to go for a surgery. However there are certain situations when you may want to go with spinal stenosis surgery. The reasons are as follows’
- Unsuccessful non surgical treatments
- Severe pain since a lengthy period of time.
- Radiculopathy i.e. pain, numbness and tingling in the arms or legs
- Loss of sensation in arms or legs
- Decreased motor strength in arms or legs
- Loss of bowel or bladder control.
There are two techniques for spinal stenosis surgery:
Depending upon the stenosis in various parts different types of surgeries are performed in different regions being cervical spinal stenosis surgery, lumbar spinal stenosis surgery which is done in the performed in the following manners:
- Decompression- The surgeon will remove tissue pressing against a nerve structure which makes more room in the spinal canal or in the foramen.
- Stabilization- The surgeon works to limit motion between vertebrae.
To remove the tissue that is pressing on a nerve the surgeon may perform one of the following types of surgery
- Foraminotomy- If a part of the disc or bone spur (osteophyte) is pressing on a nerve as it leaves vertebra (the exit called foramen), a foraminotomy may be done. Otomy- To make an opening. Thus forminotomy is making the opening of the foramen larger so the nerve can exist without being compressed
- Laminotomy- Similar to foraminotomy, a laminotomy makes a larger opening this time in the bony plate protecting the spinal canal and spinal cord in the spinal canal stenosis surgery. The lamina pressing the nerve so the surgeon may make more room for the nerves using laminotomy
- Laminectomy- Sometimes laminotomy is not sufficient thus the surgeon may need to remove all or part of lamina which is called as laminectomy.This can be done at many levels without any harmful effects. For Lumbar spinal stenosis surgery generally lumbar laminectomy is opted.
STABILIZATION SURGERY FOR SPINAL STENOSIS:
This surgery is helpful in cases where one or more vertebrae has slipped out of the correct position which makes the spine unstable. The need for stabilization also depends on how many vertebrae the surgeon needs to work on. Spine stabilization is common since many years where the surgeon creates an environment where the bones in the spine will fuse together overtime. The surgeon uses a bone graft or a biological substance which will stimulate bone growth. Spinal instrumentation like wires, cables, screws, rods and plates to increase the stability and help fuse bones is used. The fusion will stop movement between the vertebrae providing long term stability.
The surgeon will discuss all the potential risks with the patient before the surgery and sign a surgical consent form. Possible complications include, but are not limited to are:
- General risk of anaesthesia
- Injury to the spinal cord nerves
- Non healing of the bony fusion
- Failure to improve
- Instrumentation breakage or failure
- Infection and/or bone graft site pain.
Spinal stenosis surgery India is performed at a very affordable cost with at some of the best spine surgery hospitals in the major cities of India.
Spinal stenosis treatments are provided at much affordable prices without any compromise on efficacy.
- After the surgery the patient will be most likely out of bed within 24 hours and will be on pain medications for 2-3 weeks.
- After the surgery instructions will be given to how to carefully sit, rise and stand. It is important to give time to the body to heal and see the Doctor as per recommended times.
- In general patients are limited to do any activity that would move spine too much. Sports, twisting or heavy lifting is generally told to be avoided while recovery period.
- After surgery it is advised to be vigilant and report any problems such as fever, increased pain or infection to the doctor right away.
The following guidelines to be followed properly
- Following the doctor’s treatment plan
- sitting and standing properly
- Learn to lift correctly
- Exercise regularly like low impact exercise is especially good after consulting the Doctor
- Attain and maintain proper body weight
- Proper balanced diet
- Avoiding the usage of alcohol and following a healthy balanced diet
The results with spinal stenosis operation
are usually good. Generally 80-90% of patients have relief from their pain after surgery.