Another Fact of Aging — Spinal Stenosis
- Posted on: Nov 30 2016
With the passing years may come wisdom, but it also brings some degenerative issues, even with your spine. Degenerative changes in the spine — a collapsed disc, bone spurs, or cysts — can cause the spinal canal to narrow. This tightening may lead to pinching of the spinal cord, which then leads to problems with movement and coordination in the arms and legs. This narrowing is called stenosis. If it occurs in the neck, it is known as cervical stenosis. In the lower back it is known as lumbar stenosis. These conditions are progressive and usually occur in elderly patients.
While there are some options with the DFW Center for Spinal Disorders team for temporary relief from stenosis symptoms, in most cases surgery is required alleviate the decompression of the spinal cord.
Symptoms of stenosis
- Cervical stenosis will show itself in neck stiffness, weakness in the arms causing difficulty using the hands, and pain and numbness in the hands and/or arms.
- Lumbar stenosis will feature a tired, heavy feeling in the back, buttocks, and legs when walking or standing; a cramping sensation in these same areas; decreased walking ability due to weakness, numbness, or pain in the legs.
Surgical options
The first priority is to find the area or areas of decompression. To do this we utilize an MRI scan and/or a CT scan. These will usually show where the canal is too tight and the spinal cord is crowded and pinched. In spinal stenosis, stability can also be a problem, so we also test stability.
Decompression surgery is known as laminectomy and its goal is to create more space for the spinal cord and nerves to move freely, eliminating the pinching. Depending on the extent of the stenosis, one vertebra or more may be involved.
Methods of Treating Spinal Stenosis
These are some of the methods we use to treat stenosis.
- Laminectomy — This involves removal of the entire lamina (the bone that forms the backside of the spinal canal and makes a roof over the spinal cord), a portion of the enlarged facet joints, and any thickened ligaments overlying the spinal cord and nerves.
- Laminotomy — In this method a small portion of the lamina and ligaments, usually only on one side, are removed. By leaving the natural support of the lamina in place, the chances of postoperative instability are decreased.
- Foraminotomy — This is usually necessary when disc degeneration has caused the foramen, the space between the vertebrae where the nerve root exits the spinal cord, to collapse, resulting in a pinched nerve.
- Laminaplasty — In this method, the lamina is cut on one side and opened akin to a swinging door. Then the spinal cord canal is expanded to relieve compression.
In some cases to help stabilize sections of the spine that have been treated by a laminectomy, we may perform a spinal fusion. In a fusion, we use a combination of bone graft, screws, and rods to connect two separate vertebrae together into one new piece of bone.
Schedule a consutlation
Do you have weakness in your arms and hands or pain and numbness in those areas? Do have leg pain or a heavy feeling in your back, buttocks, or legs when walking or standing? You may have spinal stenosis. Call the DFW Center for Spinal Disorders, 817-916-4685, and let’s see how we can help you.
Image courtesy of stockimages at FreeDigitalPhotos.net
Posted in: Spinal Disorders
