Spinal stenosis is a narrowing of the spinal canal, which puts pressure on the spinal cord and nerves. It occurs most commonly in the lumbar spine (the lower back), but can happen anywhere in the spine.
What Causes Spinal Stenosis?
Spinal stenosis occurs when bones, discs or joints degenerate. This happens due to overuse or the wear and tear associated with aging, and may result in bulging discs, thickened spinal ligaments and enlarged joints. Vertebrae may slip out of alignment and rub against each other. This rubbing causes bone spurs to grow into the spinal canal. The resulting narrowed canal squeezes the spinal nerves, which irritates and inflames them.
Who Gets Spinal Stenosis?
Spinal stenosis mostly affects people ages 50 and up. However, some young people are born with back problems that lead to spinal stenosis, and others experience injuries that lead to the condition.
What are the Symptoms?
Occurring most often in the legs, symptoms include heaviness, weakness, and pain while walking or standing for long periods. Standing and walking stretch and press the irritated nerve, so it’s not unusual for the pain to resolve upon sitting, because the pressure is removed from the nerve roots. Sometimes, it’s more comfortable to walk when leaning forward slightly, such as with a walker or shopping cart.
Lumbar Spinal Stenosis
Lumbar stenosis occurs in the lower back and can result in symptoms of sciatica: weakness, tingling or numbness in the lower back, buttocks and legs. Although it can affect any level in the spine, it most commonly occurs at levels L4-L5 and L3-L4. Symptoms often worse with activity.
Cervical Spinal Stenosis
Spinal stenosis pain in the neck is called cervical spinal stenosis. This condition means that there is potential compression of the spinal cord. Spinal cord compression can cause extreme weakness, or in some cases, paralysis.
Anti-inflammatory drugs and short term pain medications, along with rest, relieve the pain of stenosis in many cases. Physical therapy, exercise or epidural steroid injections are other options.
If symptoms worsen, a minimally invasive surgical procedure may be required to decompress the nerves.
In a laminectomy, the surgeon makes an opening in the lamina (vertebral arch) or removes posterior structures to relieve pressure on the nerve root.
Laminectomy with Fusion
A laminectomy may be combined with a fusion to stabilize the spine. In a fusion, the lumbar disc is removed and a bone graft is placed between the vertebrae. As the graft heals, it fuses the vertebrae, resulting in a new bone mass.
Anterior Cervical Discetomy Fusion
A cervical discetomy will first remove any bone spurs and disc fragments pressing on the nerves or spinal cord. To repair the damaged disc, the surgeon then inserts an implant into the space between the vertebrae. Finally, the surgeon may need to further strengthen the reconstruction with the addition of a small metal plate and screws.
Cervical Total Disc Replacement (TDR)
A cervical TDR surgery, is performed through a one to two-inch incision in the front of the neck. The important structures of the neck are carefully moved to the side to allow the surgeon access to the cervical disc. The damaged cervical disc that is replaced with an artificial disc. The incision is closed with absorbable sutures under the skin.
If you have questions about spinal stenosis or the minimally invasive spine procedures offered by DISC of Louisiana, please contact us to schedule an evaluation at one of our clinics across the south Louisiana region.
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